Application - AIFBA

Application for Membership

P.O. Box 4528 | Atlanta, Georgia 30320 IRS: 58-1466324 https://www.aifba.com

Application Date

Company Name

Street Address

City

State

Zip

Company Number

Company Fax

Primary Contact

Primary Contact Number

Primary Contact Email

Alternate Contact 1

Alternate Contact 1 Number

Alternate Contact Email

Alternate Contact 2

Alternate Contact 2 Number

Alternate Contact Email 2

Alternate Contact 3

Alternate Contact 3 Number

Alternate Contact Email 3

Alternate Contact 4

Alternate Contact 4 Number

Alternate Contact Email 4

Alternate Contact 5

Alternate Contact 5 Number

Alternate Contact Email 5

CHB License Number

FMC License Number

IATA Number

*Membership dues include a one-time $50.00 Initiation Fee + $250.00 per calendar year. Total to join is $300.00.

AFTER SUBMISSION, YOU WILL BE DIRECTED TO SUBMIT YOUR APPLICATION FEES VIA PAYCARGO OR PAYPAL.