COPA On-Line Application

Annnual dues for COPA Membership: $65, of which $6 is used for publication of the association magazine, Cirrus Pilot
Basic Information
Enter your name and address precisely; the Postal Service will not deliver magazines to non-standard or incomplete addresses.
*First Name
*Last Name
*Address (line 1)
Address (line 2)
*City
*State / Province
*ZIP / Postal Code
Country
*Home Phone Number
(Ex: 123-456-7890)
Work Phone Number
(Ex: 123-456-7890)
Mobile Phone Number
(Ex: 123-456-7890)
Fax Number
(Ex: 123-456-7890)
*Email Address
Tell us about your airplane
Aircraft / Position Type:
Aircraft Serial or Position #
Aircraft Tail #
(Ex: N12345)
Tell us about you
Occupation
Pilot Certificate Type
Ratings CFI: Instrument: Multi-Engine:
Home Base Airport Identifier
(Ex: DLH)
Membership Options
Check here if we should NOT include your mailing and email addresses in the membership directory.
Check here if we should NOT include your phone numbers addresses in the membership directory.
Check here if we should NOT provide your name/address to third parties (i.e. advertisers).
Check here if you would NOT like to receive paper mailings (magazine, etc.) and would rather just view them all on-line.
* = Required Field
Optional Information - The following information is optional and is collected only so that we can generate aggregate statistics about the fleet and its usage. None of the information below will ever be released on an individual basis, but aggregate descriptions (averages, totals, etc.) may be released to help our membership. An example would be releasing total fleet hours to insurance companies if it helps our case. Or noting high problem incidence in certain areas of the aircraft. Please only complete this portion is you currently own or fly a Cirrus aircraft.

Total time:

Total time in last 12 months:

Total time in SR20/22:

Time in SR20/22 in last 12 months:

Total # of hours on your SR20/22:

Which avionics package do you have?

Which MFD do you have? (mfd is )

Which HSI do you have?

Which engine monitor do you have?

Do you have Stormscope?

Do you have Skywatch?

In each of the following areas, please rank your satisfaction, basd on your experience in the last 12 months, on a scale of 1-5 with the following meanings:

5 = extremely satisfied - no problems, love it!
4 = satisfied - no major problems, but it could be improved.
3 = some problems but nothing that grounded the plane or required immediate attention
2 = problems that required immediate attention but didn't result in significant downtime
1 = significant aircraft downtime as a result of this component
 If your aircraft is not equiped with the component, please leave your answer blank.

Paint & Exterior Cosmetics:

Interior Cosmetics:

Airframe Structure:

MFD

Garmin radio stack (NAV/COM/GPS):

Transponder:

HSI:

PFD:

Autopilot:

Flight Instruments (standard 6 instruments other than HSI/DG):

Other Avionics:

Flaps:

Other flight controls (elevator, rudder, ailerons):

Other Electrical:

Engine Temperatures:

Engine Starting:

Other Engine Issues:

Miscellaneous (other things not mentioned specifically here):