ACADEMY OF MODEL AERONAUTICS
Application for 2009 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, 2009
OPEN Membership $58.00 Model Aviation included. (date of birth required) ___________________________ Those 65 or over by July 1, 2009 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. ________________________________
PARK PILOT PROGRAM* $29.95 (Park Pilot magazine included) (date birth required) *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.
For those under 19 as of July 1, 2009
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 at all sanctioned events or chartered club activities. For Canadians 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. Please list current MAAC number and expiration date: _______________________________
OPTIONS:
- Museum Patron Programs
- Museum Patron $25.00
- Supporting $100.00
- Sustaining $500.00
- Life $1,000.00
- 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 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 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 ____________________________ Parent or Guardian of Applicant under age 18 must also sign _______________________
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 a membership application is received. Applications received after September 15 will be valid for 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 for the year after a correct current application and payment are received; it expires with the issue printed in December (which is dated January of the following year). Membership rates and insurance limits are those in effect at the time of printing. Actual cost of dues and amount of insurance coverage is 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.
