ACADEMY OF MODEL AERONAUTICS
Application for 2011 Membership - ONLY ONE APPLICANT PER FORM 5161 E. Memorial Dr., Muncie, Indiana 47302-9050, Fax: (765) 741-0057, www.modelaircraft.org
Mr. Mrs. Ms. New Membership Renewing Member (provide AMA number if known) ____________________
First Name ____________________________ Initial _____ Last Name _______________________________
Mailing Address (number and street) _______________________________________________________ Apt. # ________
City ________________________________ State ____________ Zip Code ______________________
Home tel. (____) ________________ Work tel. (____) ________________ FAX (____) ________________
E-mail _______________________________________________ Date of Birth (Required) _______________
E-mail has provided AMA with the opportunity to get information to our members in a timely cost-effective manner. AMA on occasion partners with reputable firms to promote products that will benefit both the member and the association. AMA does not trade or sell e-mail or mailing addresses. Do not use my e-mail address for anything other than official AMA business Do not use my mailing address for anything other than official AMA business.
MEMBERSHIP CATEGORIES * All membership categories receive full membership, liability and accident/medical insurance, and competitive privileges
Adult Memberships - For those 19 or over as of July 1, 2011 OPEN Membership $58.00 Model Aviation included. Those 65 or over by July 1, 2011 may take a $10.00 deduction in dues. Open members can subscribe to our quarterly Park Pilot magazine - $9.95 EXTRA Family Membership $30.00 Model Aviation not included. (Applies to any one adult who resides in the same household as a current OPEN member.) List current OPEN member’s name and AMA number. Name ____________________ AMA# ____________________ PARK PILOT PROGRAM* $29.95 Park Pilot magazine included. **Aircraft must not exceed 2 pounds, 60 mph, and may not be powered with an internal combustion engine. * Does not have voting rights, cannot compete in competitions, and has reduced liability insurance and no accident/medical insurance. Park Pilot members can subscribe to Model Aviation magazine - $36.00 I compete in FAI activities
Youth Memberships - For those under 19 as of July 1, 2011 Note: For competition purposes, YOUTH will be categorized as Junior (under 15 by July 1) or Senior (Those 15 by July 1 but not 19) AMA is partnering with other organizations and is now offering free youth memberships. The membership will be good until the member turns 19 as of July 1*. For more information please visit http://www.modelaircraft.org/youth FREE YOUTH membership One-year subscription of Model Aviation magazine $15.00 One-year subscription to our quarterly magazine Park Pilot $9.95
For Non-U.S. Permanent Residents AFFILIATE MEMBERSHIP $28.00 insurance only while flying in the USA. Model Aviation not included. Membership in National Aero Club (NAC) is required. Please provide copy of NAC membership card/record. Name of National Aero Club ____________________ Expiration Date _______________ AFFILIATE MAGAZINE SUBSCRIPTION add $60.00 for a total of $88.00. Canadian Residents: AMA has a reciprocal agreement with MAAC. A current MAAC card will be honored at all sanctioned events or chartered club activities.
Recruiter Information: If you were recruited to join AMA by a member, AMA Club, or hobby shop, please indicate only one and list the name and AMA number (if known) so we can thank them. Member - Name ____________________ AMA# ____________ Club - Name ____________________ Club Charter # ____________ Hobby Shop ____________________ Hobby Shop # (if applicable) ____________
Area of Interest: Please select one Primary Interest then select one Area of Participation within your Primary Interest. CONTROL LINE
- Aerobatics
- Carrier
- Combat
- Racing
- Scale
- Speed
- Sport
- Electric
FREE FLIGHT
- Indoor
- Outdoor
- Scale
RADIO CONTROL
- Electric Indoor
- Electric Outdoor
- Scale
- Giant Scale
- Helicopter
- Pattern
- Pylon
- Combat
- Park Flyer
- Sport
- Jets
- Soaring
- 3D
ROCKETRY
Contribution Options National Site Development
- $25.00
- $50.00
- $100.00
- Other $ _______
Add $4.00 for Model Aviation mailed in a protective covering
Museum Patron Programs
- $25.00/Patron
- $50.00/Supporting
- $100.00/Sustaining
- $1000.00/Life
METHOD OF PAYMENT VISA MasterCard Check enclosed Amount $ _______ Card No. __________________________ Exp. Date _______ Signature ___________________________
Please read and sign this declaration. Applications without a signature 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 does not 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 Safety Code may endanger my liability coverage for any damages or claims so caused. I further understand that written notice of the occurrence of any incident must be immediately provided." "I am aware that modeling may present hazards to participants and spectators. I accept, waive, and release the Academy of Model Aeronautics, Incorporated (AMA) from all current or future liability for personal injury, property damage, or wrongful death caused by negligence."
Signature of Applicant _____________________________ Date _______________ Parent or Guardian of Applicant under age 18 must also sign _____________________________ Date _______________
Membership ends each year on December 31, regardless of the date a membership application is received. All membership benefits begin on the day of receipt at AMA Headquarters of a properly completed application and correct dues payment. Applications received after September 15 will be valid through the remainder of that year and all of the following year. If a magazine is included with the membership, it begins with the first issue available after the payment is received. Membership or other correspondence and payments sent to clubs, contest directors or distributors are not considered delivered until received by AMA Headquarters. Any changes in name or address should be reported promptly to AMA Headquarters. Failure to receive a membership card does not affect membership status. Any such changes will be noted at the time of membership processing so they may be accepted or not.
Transcribed from original scans by AI. Minor OCR errors may remain.
