R ___ J ___ CHESANING AREA MODEL FLYING CLUB, INC. MEMBERSHIP APPLICATION Please Print NAME____________________________________________________MALE _____ FEMALE _______ ADDRESS____________________________________ CITY _________________ ZIP CODE ________ PHONE NUMBER (____) ______________ BIRTHDATE ______/______/______ SENIOR (65+) _____ OCCUPATION ________________________ CLUB SPONSOR _________________________________ E-MAIL ADDRESS ____________________________________________________________________ HAVE YOU FLOWN R/C? _____ NUMBER OF YEARS _____ INSTRUCTOR NEEDED ________________ AMA NUMBER ______________________ OTHER R/C CLUB’S _________________________________ HANDICAPPED (EXPLAIN) ______________________________________________________________ UPON MAKING APPLICATION, I WILL HEREBY AGREE TO THE FOLLOWING RULES:  I WILL SHOW PROOF OF AN AMA MEMBERSHIP OR APPLICATION FOR AMA MEMBERSHIP.  I WILL ABIDE BY ALL THE RULES AND REGULATIONS SET BY THE CLUB AND AMA BY-LAWS.  I WILL FLY ON THE AMA APPROVED FREQUENCY.  I WILL PARTICIPATE AT ANNUAL SWAP MEET OR PAY $50 NON-ATTENDENCE FEE.  MEMBERSHIP FEES: REGULAR MEMBERS - $20 DUES, $120 ASSESSMENT LIFE MEMBERS - $0 DUES, $120 ASSESSMENT JUNIOR MEMBERS - $10 DUES, $0 ASSESSMENT  PAYMENT OF CLUB DUES AND ANY SPECIAL ASSESSMENT PAYMENTS ARE TO BE MADE AT THE SAME TIME (SINGLE PAYMENT) AND ARE DUE MAY 1 WITH A 15 DAY GRACE PERIOD. AMA MEMBERSHIP MUST BE CURRENT AT THE TIME OF PAYMENT.  CLUB DUES ARE TO BE PAID TO THE CLUB TREASURER.  THE MEMBERSHIP YEAR WILL RUN FROM MAY 1 TO APRIL 30. AFTER READING THE ABOVE I AGERE TO ABIDE BY ALL RULES SET FORTH. SIGNATURE ___________________________________ DATE ________ WITNESS _______________ Membershipapp/rev 3/15