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FEATURED PILOT: FEATURED PILOT:
Capt. Harry Harvey Lero, C.E.O. and Chief Pilot of Airgurus Ltd. Co., is the master of the skies. » Read More
FEATURED AIRCRAFT: FEATURED AIRCRAFT:
Versatility... Reliability... Power and Value... The Bell 206L3 LongRanger is the captain of Airgurus' fleet of helicopters. » Read More
FEATURED AIRPORT / HELIPAD: FEATURED AIRPORT / HELIPAD:
Airgurus' own helipad is found at the Delta Air Hangar, Manila Domestic Airport Road, Pasay City, Philippines 1300. » Read More
FEATURED VIDEO: FEATURED VIDEO:
This is a view of Manila... by night. » Read More
MONTHLY CONTEST: MONTHLY CONTEST:
Airgurus has a monthly online contest for the Airgurus Fans » Read More
LATEST PROMO: LATEST PROMO:
See our latest promos here... » Read More
FAQ: FAQ:
Frequently Asked Questions... » Read More

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Online Application

PERSONAL INFORMATION

NOTE:

Name to appear on card(Must not exceed 20 characters).

If not applicable, please type N/A.

* - Required fields.

*Last Name

*First Name

*Middle Name

*Birtdate
(mm/dd/yy)

Birthplace

*Gender

Female

Male

*Civil Status

Single	Married
Separated	Widowed

*Name of Spouse

Birthdate

*List of Dependents				Birthdate

*Email Address

Citizenship

*Home Address				Zip Code
Mobile Number				*Home Phone Number
Employer/ Business Name				Position

Business Address

Note: Person to notify in Case of Emergency
*Name(Last Name, First Name, Middle Name)

*Relationship

*Contact Number

MEMBERSHIP APPLICATION

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* - Required fields.

*Type Of Plan

*Duration of Plan

Individual

Couple

Family

Corporate

7 Days

15 Days

One Month

Six Months

One Year

MEDICAL INFORMATION

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* - Required fields.

*Have you been hospitalized in the last six months?

Yes

*Have you ever availed of any medical or surgical treatment? (If yes, please give details below)

Yes

*Are you presently taking any medication? (If yes, please give details below)

Yes

*Do you take alcohol, cigarettes, tobacco or any habit-forming drug?

Yes

PAYMENT INFORMATION

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*Modes of Payment

Annually

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Check

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Number	Amount

*Bank / Credit Card Name

Branch Location

AGENT INFORMATION

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*Name of Agent

Date of Membership

I have read and understood, and agree to the Terms and Conditions. I certify that the information contained in this application form is accurate and complete. I understand and agree that failure to fully complete the form, or misrepresentation of omission of facts, represents grounds for elimination from consideration or termination of membership if discovered at a later date.

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