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North Star Flyers
Chit Submission Form
Date Time
*
MM
/
DD
/
YYYY
Pilot Name
*
Aircraft
*
Please select
Sundowner N839KT $165/hr Tach
Skyhawk N79567 $130/hr Hobbs
Warrior N22473 $135/hr Hobbs
Citabria N5038M $130/hr Hobbs
Arrow N15380 $185/hr Tach
Lark N4099X $150/hr Tach
None
Ending Hobbs
Ending Tach
*
Flight Time (if using tach, round to nearest 0.1)
Anoka Fuel Added
*
Oil Added
*
Flight Charge
(Rate table at bottom)
$
Dollars
.
Cents
Fuel Credit
(Copy of receipt required)
$
Dollars
.
Cents
Fuel credit: Gallons added (Required if credit sought)
Dues ($65/month, $715/year)
$
Dollars
.
Cents
Total Paid
$
Dollars
.
Cents
Payment Source
Paid by check
Deduct from prepaid acct
Paid by Venmo
Adding to prepaid account
Currency Flight?
Flight Review
Flight with Club CFI
Squawks/Comments