AMA Membership Application
Academy of Model Aeronautics 5161 E. Memorial Dr. Muncie, IN 47302 1-800-435-926
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 number: (____) ____-____
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) _______________________
Membership Categories
For those 19 or over as of July 1:
- o Open Membership - $48.00 (Model Aviation included)
- o Senior Citizens (age 65 or older as of July 1) may take an optional $10.00 reduction in dues. (Must submit proof at time of original application.)
- o Extra Family Membership - $30.00 This category applies to any one adult who currently resides at the same address as a current Open Member; magazine not included.
- o Youth Membership - $1.00 (magazine not included) — at time of original application. [Note: appears duplicated; see below for youth under 19.]
For those under 19 as of July 1:
- o Youth Membership - $13.00
For HQ Use Only
Current Open member's name and ___________________________ AMA number ______________________
Options:
- o FAI Stamp $35.00
- o National Site Development $________
- Add $6.00 for Model Aviation mailed in an envelope
Payment: $ ________
- o Check
- o VISA
- o MasterCard
Credit Card No. __________________________________ Exp. Date ___ / ___
Card Holder's Signature _______________________________
Interests and Participation
Primary Interests (check one):
- o Control Line
- o Free Flight
- o Radio Control
- o Rocketry
- o Electric
- o Pylon
- o Aerobatic
- o Racing
- o Indoor
- o Outdoor
- o Helicopter
- o Soaring
- o Combat
- o Scale
Area of participation (check one):
- o Speed
- o Carrier
- o Scale
- o Pattern
- o Sport
- o Jets
Waiver, Release, and Safety Code
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 may affect my liability insurance coverage.
Safety Code compliance and waiver and release of liability statement:
I agree to comply with the AMA Safety Code for all applicable model operations. I understand that my failure to comply with the Code will result in failure of liability coverage.
Insurance coverage is effective on the date of receipt at AMA Headquarters of a properly completed application and correct dues payment.
Membership ends each year on December 31, regardless of the date a membership application is received. Applications received after October are valid for the remainder of that year and all of the following year. If a magazine is included with the membership, it begins with the issue available for the year after a correct current application and payment are received; it expires with the issue printed in December (which [sic] February of the following year). Membership rates and insurance limits are those in effect at the time of printing.
Actual cost of dues
August 2001
Transcribed from original scans by AI. Minor OCR errors may remain.
