AMA Membership Enrollment Form
ACADEMY OF MODEL AERONAUTICS Enrollment form for 2014 Membership - ONLY ONE FORM PER INDIVIDUAL 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 _________________________________ Date of Birth _______________
Mailing Address (number and street) __________________________________________________________ Apt. # ______
City ________________________________ State ____________ Zip Code ________________________
Contact Telephone: ( __ ) ________________ Email ___________________________________________
MEMBERSHIP CATEGORIES
* All membership categories receive full membership, liability and accident/medical insurance, and competitive privileges
[ ] OPEN Adult Memberships (For those 19 or over as of July 1, 2014) $58.00. Choice of one of the following Model Aviation subscriptions included. Learn more at www.ModelAviation.com/digital. [ ] Print Edition [ ] Enhanced Digital Edition [ ] Receive both Print and Digital $9.95
NEW OPEN Members - New AMA members joining during these periods will receive a prorated membership price. [ ] April 1st through June 30th $43.50 [ ] Print Edition [ ] Enhanced Digital Edition [ ] Receive both Print and Digital $9.95 [ ] July 1st through September 14th $29.00 [ ] Print Edition [ ] Enhanced Digital Edition [ ] Receive both Print and Digital $9.95
[ ] OPEN Senior Membership $48.00 Model Aviation included. (For those 65 or over by July 1, 2014.) Choice of one of the following Model Aviation subscriptions included. Learn more at www.ModelAviation.com/digital. [ ] Print Edition [ ] Enhanced Digital Edition [ ] Receive both Print and Digital $9.95
NEW OPEN Senior Members - New AMA members joining during these periods will receive a prorated membership price. [ ] April 1st through June 30th $36.00 [ ] Print Edition [ ] Enhanced Digital Edition [ ] Receive both Print and Digital $9.95 [ ] July 1st through September 14th $24.00 [ ] Print Edition [ ] Enhanced Digital Edition [ ] Receive both Print and Digital $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 fire, theft, or accident/medical insurance. [ ] Add Model Aviation print magazine - $36.00 [ ] Add Model Aviation Enhanced Digital Edition - $36.00 [ ] Add Model Aviation Print and Digital $45.95
[ ] FREE YOUTH MEMBERSHIP - For those under 19 as of July 1, 2014. [ ] Add Model Aviation print magazine - $15.00 [ ] Add Model Aviation Enhanced Digital Edition - $15.00 [ ] Add Model Aviation Print and Digital $24.95 [ ] Add Park Pilot print magazine - $9.95 [ ] Add Park Pilot print and Model Aviation print $19.95 [ ] Add Park Pilot Print and Model Aviation Digital $19.95 $19.95 Add Park Pilot Print and both Print and Digital Model Aviation $24.95 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).
[ ] AFFILIATE MEMBERSHIP $28.00 (For non-U.S. permanent residents). Insurance and competitive privileges only while flying in the USA. AFFILIATE DIGITAL MAGAZINE SUBSCRIPTION add $36 for a total of $64
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. Name _______________________________________________ AMA# ____________
[ ] Add $4.00 for Model Aviation mailed in a protective covering
SUPPORT AMA PROGRAMS
Scholarship Fund [ ] $25 [ ] $50 [ ] $100 Other $_____ National Site Development [ ] $25 [ ] $50 [ ] $100 Other $_____ Disaster Relief Fund [ ] $25 [ ] $50 [ ] $100 Other $_____ Government Relations [ ] $25 [ ] $50 [ ] $100 Other $_____ Museum Patron Program [ ] $25/Patron [ ] $100/Supporting [ ] $1000/Life Other $_____
Area of Interest: Please select one. [ ] RADIO CONTROL [ ] CONTROL LINE [ ] FREE FLIGHT [ ] ROCKETRY
METHOD OF PAYMENT
[ ] VISA [ ] MasterCard [ ] Discover [ ] Check enclosed
Card No. ____________________________________________________ Amount $__________
Exp. Date ____ / ____ Signature ___________________________________________
If I am involved in any claim or suit I will not sue the AMA, Inc. I understand that this does not affect my liability insurance coverage. "I agree to comply with the AMA Safety Code."
Signature of Applicant ________________________________________
Membership ends each year on December 31, regardless of the date a membership form is received. All membership benefits begin on the day of receipt at AMA Headquarters of a properly completed form and correct dues payment. If a magazine is included with membership, it begins with the first issue available for the year after a correct current form and payment are received; if copies are not available at the time of joining, they will be mailed when available. Membership benefits may be affected by changes in AMA policies. Annual dues and magazine subscription offerings are subject to change. Any such changes will be posted under the membership section of www.modelaircraft.org. Forms received after September 15 will be valid for the remainder of that year and all of the following year.
Transcribed from original scans by AI. Minor OCR errors may remain.
