Please follow the instructions below to apply for BASA membership. If you have any questions, please email our membership chairmain at

  1. Read, sign, and send the liability release form to You may sign the form without printing or scanning using a Mac, or using Adobe Reader.
  2. Complete the form below.
  3. Our membership chairman will follow up with you promptly.
Name *
Address *
Is your address registered with the FAA? *
If not, do it immediately
Date of Birth *
Date of Birth
Home Phone *
Home Phone
Work Phone
Work Phone
Mobile Phone
Mobile Phone
Next of Kin *
Next of Kin
Address of Next of Kin *
Address of Next of Kin
First glider flight *
First glider flight
Last biennial flight review date *
Last biennial flight review date
Launch Type Qualifications
Accident History
If any of the following are yes, a detailed explanation is required.
Have you had an accident while PIC? *
Have you ever been cited for violation of FAA or Military Aviation Regulations? *
Are you flying subject to any limitations, waivers, or restrictions? *
Have you ever had an application for aircraft insurance declined? *
Date, location, make & model of aircraft, and cause
Flight History
I have CFI-G signoffs in my logbook for the following
By checking "Agree," I certify that I will fly only those BASA aircraft for which I have a CFI-G signoff and flight committee approval *
By checking "Agree" and submitting this application, I certify that all information provided by me on this application is true and verifiable by independent documentation or the FAA. *