Hot Air Ballooning - Pennine Region Balloon Association

Membership Application form

Membership Fee £10.00 annually
Please complete and send your cheque made payable to PRBA to:

Brian Trowbridge
192 Blenheim Drive
Allestree
Derby
DE22 2GN

or, if you prefer a paper-based process, click here

(* are minimum details required)

First name

Surname

* Your Name:

Other family members' names:

Address:

Town:

Postcode:

County:

* Home tel:

Business tel:

Mobile:

* Email:

Balloon details (if applicable):

Manufacturer:

Size/Type:

Reg:

Artwork:

Colours:

Balloon name:

Type of Pilots Licence:

PPL CPL PUT None

Other qualifications:

Examiner: Instructor: Inspector: Observer:

Available to Crew:

Yes: No:

Vehicle Driving Licence:

Yes: No:

It would help if we could send you eNews bulletins and our newsletter, 'SCOOP' by email. Please check the boxes below to accept:

eNews Bulletins: SCOOP:

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




© 2007 Pennine Region Balloon Association	Web site provided by John Hartley Associates