Membership Application
ACADEMY OF MODEL AERONAUTICS
Application for 2006 Membership - One Individual Per Application
Please type or print the information clearly in CAPITAL letters. When completed, this form can be mailed with payment to AMA, 5161 E. Memorial Dr., Muncie, Indiana 47302-9252, Fax: (765) 741-0057, www.modelaircraft.org
Mr. ___ Mrs. ___ Ms. ___
First Name ____________________ Initial ____ Last Name ____________________
Mailing Address (number and street) ________________________________________ Apt. # _______
City ___________________________ State ________ Zip Code ________
Home tel.: (____) ________ Work tel.: (____) ________ FAX: (____) ________
E-mail: ______________________________________ □ New □ Renewal (give old number if known)
E-mail has provided AMA with the opportunity to get information to our members in a timely cost-efficient 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. If you would prefer that we not include your name, please check the box(es) below.
□ Please do not use my E-mail address for anything other than official AMA business. □ Please do not use my mailing address for anything other than official AMA business. □ Yes, I was recruited by an AMA member. Member’s name _______________________ AMA #: _______
MEMBERSHIP CATEGORIES: All membership categories receive full membership and competition privileges, liability and accident/medical insurance.
For those 19 or over as of July 1, 2006
□ OPEN Membership $58.00. Model Aviation included. (date of birth required) Those 65 or over by July 1, 2006 may take a $10.00 deduction in dues.
□ EXTRA Family Membership $30.00. (Applies to any one adult who resides in the same household as a current OPEN member.) Magazine not included. List current OPEN member’s name and AMA number. ___________________________
For those under 19 as of July 1, 2006
□ YOUTH Membership $15.00 (Model Aviation included) (date of birth required) □ YOUTH NO MAGAZINE Magazine not included $1.00 (date of birth required)
For Non-US and North American Permanent Residents
□ AFFILIATE MEMBERSHIP $28.00 insurance only while flying in the USA. Magazine not included. Name of National Aero Club _____________________ Expiration date _______
□ AFFILIATE MAGAZINE SUBSCRIPTION to non-US address - add $60.00 for a total of $88.00.
For Canadian Residents
AMA has a reciprocal agreement with MAAC. A current MAAC card will be honored for all sanctioned events or chartered club activities. For Canadian members desiring AMA membership in addition to MAAC, choose either Open or Youth membership categories listed above. An additional $24.00 postage and handling is required for magazine delivery outside the United States.
OPTIONS:
Museum Patron Programs
- Museum Patron $25.00
- Supporting $50.00
- Sustaining $100.00
- Life $1,000.00
□ FAI Stamp $50.00 □ Donation $______ □ Add $4.00 for Model Aviation mailed in a plastic protective covering.
Control Line
- □ Aerobatic
- □ 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
- □ Jet
- □ Soaring
□ Rocketry
□ I compete in FAI activities
PAYMENT OPTIONS: Check enclosed $________ Charge my □ VISA □ MasterCard $
Card No. __________________________________________________ Exp. date ___ / ___ Cardholder's signature _______________________
Please read and sign this declaration. Applications without signatures will be returned. Note: This waiver means that if I am involved in any claim or suit I will not use 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 AMA modelers may present hazards to participants and spectators. I exempt, waive, and relieve 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 _________________
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 the application is received. Membership and insurance are renewable yearly. Membership in AMA is subject to acceptance by the Academy of Model Aeronautics. Membership entitles the member to the insurance coverage in effect at the time of acceptance. The Academy of Model Aeronautics will not be held liable for errors in membership processing or delays resulting from postal or other handling. Actual cost of dues and amount of insurance coverage are subject to change. Any such changes will be noted at the time of membership processing so they may be accepted or not.
ONLY ONE APPLICANT PER FORM
Transcribed from original scans by AI. Minor OCR errors may remain.
