Pennine Region
Balloon Association

HOME

Application for Membership

Please print, complete, and return with your cheque made payable to PRBA to:


Wendy Hill
59 Lancaster Park Road,
Harrogate,
North Yorkshire
HG2 7SN


Name:
Address:
Postcode:
Home tel:
Business tel:
Mobile:
Email: 
Balloon Type:
Manufacturer:
Size/Type:
Artwork:
Colours:
Name:


Type of Pilots Licence: PPL CPL PUT

Available to Crew: Vehicle Driving Licence:

Membership Fee £10.00 annually



Data Protection Act: Please note the above information will be stored on computer, if you have any objection to this please state