SRA MEMBER INFORMATION MODIFY FORM Name: Address: City: State, Zip: Email address: Home Telephone #: Work Telephone #: Fax #: Primary Interest: Contest Pilot Contest Official Racing Enthusiast Sailplane Make/Model: Competition Number: F.A.I. Class: Standard Class 15 Meter Class Open Class Sports Class Motorglider Class World Class Highest Badge or Leg: Silver Distance Silver Duration Silver Altitude Silver Badge Gold Distance Gold Altitude Gold Badge Diamond Distance Diamond Goal Diamond Altitude 1000K Diploma 2000K Diploma SSA Membership #: Club/FBO Name: Soaring Site: Anticipated Contests:
Name: Address: City: State, Zip: Email address: Home Telephone #: Work Telephone #: Fax #: Primary Interest: Contest Pilot Contest Official Racing Enthusiast Sailplane Make/Model: Competition Number: F.A.I. Class: Standard Class 15 Meter Class Open Class Sports Class Motorglider Class World Class Highest Badge or Leg: Silver Distance Silver Duration Silver Altitude Silver Badge Gold Distance Gold Altitude Gold Badge Diamond Distance Diamond Goal Diamond Altitude 1000K Diploma 2000K Diploma SSA Membership #: Club/FBO Name: Soaring Site: Anticipated Contests: