GRASSFIELD R/C
CLUB, INC. #1405
2012
MEMBERSHIP APPLICATION
_______________________________________________________________________________________________
Membership in Grassfield R/C Club implies and requires
service to the Club.
Membership also requires:
·
Proof of Current A.M.A. membership
(applications are available from the Club and in issues of Model Aviation)
·
Completing all parts of this
application form with proper signature of applicant and guardian for minors.
·
Paid dues (and initiation fee for new
Open and Senior members not a member in 2011).
·
Adherence to both Grassfield R/C Club
rules and AMA rules (indicated by signature on application).
Membership Dues: Please circle all that apply.
·
Open $65 for those 19 or older by July 1, 2012, (add $20 for new
members - see initiation)
·
Senior $45 for those 65 or older by July 1, 2012, (add $20 for new
members - see initiation)
·
Student $20 for
students 19 to 23 by July 1, 2012. (must include a copy of school ID card)
·
Junior $20 for those not yet 19 by July 1, 2012.
·
Initiation $20 initiation
fee (New Open and Senior members only).
·
Newsletter $25 Newsletter
only membership
·
Late fee $10 for
renewing 2012 Open and Senior members applying after
4-6-2012.
Make all checks payable to:
Grassfield R/C Club
Return this form, appropriate dues, a
copy of your AMA card, and a self addressed stamped envelope to:
Grassfield
R/C Club Questions?
Del
Berryman Secretary Del Berryman
12967 192 ½ Circle NW
612-799-6247
Elk
River,MN
55330-4400 del31@charter.net
2012 membership renewal is required by 4/16/2012 to avoid
paying the $10.00 late fee.
If you join after September 1,2012,yourmembership
will be good for 2012 and 2013.
You must send a photocopy of your AMA card if applying by
mail.
NAME___________________________________ HOME PHONE_____________________________
ADDRESS________________________________
AMA#_____________________________________
CITY_____________________________________
FREQ.____________________________________
STATE____________
ZIP___________________
E-MAIL____________________________________
BIRTHDATE_______________________________
Club Help.
q Grass
mowing
q Race
help
q Event
CD
q Other
event help
q Field
maintenance
q Instructor
q I
need flight instruction in 2012. (special forms must be filed with club prior
to instruction – please call)
q I
am an experienced flier and don’t need instruction.
New experienced members only.( must check one box)
q I
am ready for a competency checkout flight.
q I
have a letter from a previous club officer indicating flight competence.
Club Use Only |
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App Date: |
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Paid Date: |
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Check # |
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AMA Ver. |
|
Card Iss. |
I agree to comply with the safety rules of GRC Club & AMA for 2012, and fulfill the requirements of membership therein:
Parent/Guardian: __________________________________ Date: __________________________