AMA Membership Application
ACADEMY OF MODEL AERONAUTICS
Application for 2003 Membership - One Individual Per Application
(Detach and return to: Academy of Model Aeronautics, 5161 E. Memorial Dr., Muncie, IN 47302. Make check or money order payable to: Academy of Model Aeronautics.)
First Name: ______________________ Initial: ___ Last Name: ______________________
Billing Address (number and street): __________________________________________________
City: ____________________________ State: _____ Zip Code: __________
Home tel.: (_____) ______ - ________ Work tel.: (_____) ______ - ________ Fax: (_____) ______ - ________
E-mail: __________________________________ New □ Renewing (same as number above) □
□ Yes, I am covered by an AMA insurance policy through my club. Club name: ___________________
MEMBERSHIP CATEGORIES: All new benefits categories receive full membership services. For privileges including your journal and insurance, please select one.
For those age 19 or over as of July 1, 2003:
- □ FULL MEMBERSHIP (includes AMA magazine, liability insurance) - $50.00
- □ EXTRA MAGAZINE SUBSCRIPTION (add to Full Membership; allows two magazines to be mailed to different addresses) - $10.00
For those under 19 as of July 1, 2003:
- □ YOUTH (includes AMA magazine and limited insurance) - $10.00
- □ YOUTH - Add an extra magazine - $5.00
For Non-US and North American Permanent Residents:
- □ AFFILIATE MEMBERSHIP (no insurance; for overseas members) - $25.00
- □ AFFILIATE MAGAZINE SUBSCRIPTION (one-year, for members; add $30.00 to $55.00)
For Canada residents:
- Canadian residents please remit in U.S. funds. Canadian membership rates and magazine subscription rates available from the AMA office.
Check applicable extras and donations:
- □ Publications (additional)
- □ Events support
- □ Education programs
Hobbies/Interests (check all that apply):
- Free Flight □
- Control Line □
- Radio Control □
- Gliders □
- Electric □
- Scale □
- Combat □
- Indoor □
- Jets □
- Pattern □
- Sport □
- Helicopter □
- Other: ____________________
Club No.: __________ Check enclosed: $________ Charge my: □ Visa □ MC □ AmEx Card number: _______________________________ Exp. Date: ______ / ______
Signature: ______________________________________ Date: ______________
I agree to comply with the Academy of Model Aeronautics Safety Code and the rules and regulations as published. I understand that membership is contingent upon my adherence to AMA policies and that insurance coverage, where applicable, is subject to the terms and limitations of the policy.
Only one applicant per form.
Transcribed from original scans by AI. Minor OCR errors may remain.
