APPLICATION FOR MEMBERSHIP

Please complete this form in its entirety before submission. You can save your progress at any time and you will be issued a Temporary ID that will allow you to return and complete the form at your convenience.
Enter your Temporary ID to Update information
Personal Information
 
 
 
 
 
   
 
   
 
 
 
Current Airline Employment Information
 
 
 
 
 
 
Previous Employment In Aviation

Please use the tool below to build your Employment History by completing the following fields and then selecting the Add button. There is no limit to the number of previous employments that can be added.

Flightcrew Member Education and Qualification

Please use the tool below to build your Flight Education & Qualification history by completing the following fields and then selecting the Add button. Multiple entries are allowed.

Pilot License Type & Flight Time Record

Military Experience

Please use the tool below to build your Military Experience history by completing the following fields and then selecting the Add button. Multiple entries are allowed.

Union Data
 
 
 
 
 
ALPA Apprentice Member Insurance Opt-In Form

 

  • $1,200 Monthly Loss of License, underwritten by Guardian Life Insurance Company of America;
  • $50,000 Group Term Life, underwritten by Guardian Life Insurance Company of America;
  • Group Critical Illness Insurance ($10,000 maximum Critical Illness benefit) and Group Accident Insurance (benefit amounts depend on the type of injury and care received) underwritten by ReliaStar Life Insurance Company, a member of the Voya® family of companies. These are limited benefit policies. They are not health insurance and do not satisfy the requirement of minimum essential coverage under the Affordable Care Act.
  • Coverage will begin on the first of the month following the date I elect coverage
  • I understand that the coverage is complimentary for 12 months following my date of hire, and
    • A VEBA-sponsored supplement of 50% will apply to the coverage from the 13th to the 24th month following my date of hire.
    • After 24 months, I will be billed the applicable published rates based on my age and smoker status. I will be automatically billed for payment of coverages unless I specifically request the cancellation of coverage and that I will be responsible for paying this coverage at the applicable rates.

Signature