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 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) at time of original application.
For those under 19 as of July 1:
- Youth Membership - $13.00
AMA number ____________________________ Current Open member's name and ___________________________________________________
Options
- FAA Stamp $35.00
- National Site Development $_____
- Add $6.00 for Model Aviation mailed in an envelope
Amount enclosed: $ ______
- Check
- VISA
- MasterCard
Exp. Date ____ / __ Credit Card No. _________________________________
Card Holder's Signature ____________________________
Interests and Participation
Primary Interests (check one):
- Control Line
- Free Flight
- Radio Control
- Rocketry
- Aerobatic
- Racing
- Indoor
- Electric
- Pylon
- Outdoor
- Helicopter
- Soaring
- Combat
- Scale
Area of participation (check one):
- Speed
- Carrier
- Scale
- Pattern
- Sport
- Jets
Safety Code Compliance and Waiver and Release of Liability Statement
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.
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 31 will be 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 is February of the following year). Membership rates and insurance limits are those in effect at the time of printing. Actual cost of dues.
Transcribed from original scans by AI. Minor OCR errors may remain.
