Membership Form

YES! I accept your invitation to become a member of the Clipped B's. RenewalNew Member

If you were a member last year, has your information changed?No ChangesHas Changed

Here are my annual dues in the amount of $30.00Mailing Dues with a copy of this form

Listing in the year book (Please Print Clearly)MrMissMsMrs

Full Name

Address

City, State, Zip Code

Home phone

Cell Phone or Alternate Phone

Email Address

Buzz Notes by Email only or US Mail? Email OnlyUS Mail

Name as Braniff Flight Attendant

Years as Braniff Flight Attendant from 19____

Years as Braniff Flight Attendant until 19_____

Birthday

Select Chapter AffiliationDAL HOUSATDENLAXMSPMKC

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