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.
- New member
- 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
- 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:
- Open Membership - $48.00 (Model Aviation included)
- Senior Citizens (age 65 or older as of July 1) may take an optional $10.00 reduction in dues. (Must submit proof of age at time of original application.)
- 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.
- Youth Membership - $1.00 (magazine not included)
For those under 19 as of July 1:
- Youth Membership - $13.00
AMA number ________________________
Current Open member's name and ________________________________
Options
- FAI Stamp $35.00
- National Site Development $_____
- Add $6.00 for Model Aviation mailed in an envelope
Total $ ___________
- Check
- VISA
- MasterCard
Credit Card No. __ __ __ __ - __ __ __ __ - __ __ __ __ - __ __ __ __ Exp. Date ____ / __
Card Holder's Signature _________________________________
Primary Interests (check one)
- Control Line
- Free Flight
- Radio Control
- Rockets
(check one)
- Aerobatic
- Racing
- Indoor
- Electric
- Pylon
- Helicopter
- Soaring
- Combat
- Scale
- Outdoor
Area of participation (check one)
- Speed
- Carrier
- Scale
- Pattern
- Sport
- Jets
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 1 will be valid for the remainder of that year and 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 is sent in February of the following year). Membership rates and insurance limits are those in effect at the time of printing.
[End of form]
Transcribed from original scans by AI. Minor OCR errors may remain.
