2001 Membership Application

90 M ODEL AVIATION
2 0 0 1 M e m b e r s h i p A p p l i c a t i o n
Academy of Model Aeronautics 5151 E. Memorial Dr. Muncie, IN 47302 1-800-2435-926
Only one applicant per form. You may photocopy if needed.
o New member o Renewal: give old number if known
First Name Initial Last Name
Mailing Address (number and street)
City State Zip Code
You may send this application by fax if paying by VISA or MasterCard. Fax Number:
1-765-741-0057
o Yes, please send a confirmation to: Fax nu(_m_b _e_r _:_) __ __ __ -
__ __ __ __
Home phone number: (___ ___ ___) ___ ___ ___ - ___ ___ ___ ___ E-mail Address_____________________________________
Work phone number: (___ ___ ___) ___ ___ ___ - ___ ___ ___ ___
All membership categories receive full membership and competition privileges, liability and accident/medical Insurance.
Date of Birth (requested for all applicants) _________________________________
For those 19 or over as of July 1, 2001
o Open Membership - $48.00M odel Aviatioinnclude.d
o Extra Family Membership - $30.00 This category applies to . N EW REDUCED
PRICE
any one adult who currently resides at the same address
as a current Open Member, magazine not included.
For those under 19 as of July 1, 2001
___________________________________________________ o Youth
Membership - $13.00 M-o del Aviatioinncluded.
Current Open memberÕs name and AMA number .
o Youth
Membership - $1.00 - magazine not included.
For those 65 or over as of July 1, 2001
o Senior Citizen Membership - $38.00 (Must submit proof of age at time of
original applicatiMoond)e.l Aviatioinncluded.
Options:
Museum Patron Programs
o Museum Patron $25.00 o FAI Stamp $35.00
o Supporting $100.00 o National Site Development $___________
o Sustaining $500.00 o Add $6.00 for Model Aviation mailed in an
envelope
o Life $1,000.00
$ o Check o VISA o MasterCard
Credit Card No. ____ ____ ____ ____ - ____ ____ ____ ____ - ____ ____ ____ ____ - ____ ____ ____ ____ Exp. Date ____ / Card HolderÕs Signature
Primary Interes:ts o Control Line o Free Flight o Radio Control o
Rocketry (check one) o Aerobatic o Racing o Indoor o
Electric o P y l o n o Jets
o Combat o Scale o Outdoor o Helicopter o Soaring
Area of participat:ion o Speed o Carrier o Scale o Pattern o Scale
(check one) o Sport o Sport
Everyone MUST read and sign below - Applications without signatures will be returned.
Note: this waiver means that if I am involved in any claim or suit I will not sue the AMA, Inc. I understand that this waiver affect my liability Insurance coverage.
FOR HQ USE ONLY
PFOR HQ USE ONLY