ALOHA STATE RADIO CONTROL CLUB
2010
MEMBERSHIP
APPLICATION
_____
Renewal _____ New
NAME ____________________________________________________ A.M.A. #
_________________________
NAME ____________________________________________________ A.M.A. #
_________________________
ADDRESS___________________________________________________________________________________
CITY
_______________________STATE________________ ZIP _____________________________________
PHONE (HOME) ______________________________(WORK)
______________________________________
EMAIL ADDRESS
___________________________________________________________________________
Annual Dues:
_____ Adult $25
_____ Family $35*
_____ Junior (under 18)
$15
_____ Associate (limited
privileges) $15
* family members must have individual A.M.A. numbers
Make checks payable to: ASRCC
TOTAL DUES ___________________
I the undersigned, am a current holder of a 2008
I will, as a privileged member of the
APPLICANT(S) SIGNATURE(S) ________________________________ DATE
________________
APPLICANT(S) SIGNATURE(S) ________________________________ DATE
________________
Interest (circle those that may apply to you):
Aerobatics 1/12 scale combat Fun-fly Gliders Helicopters Jets Scale Giant Scale Pattern Pylon racing
Frequencies
(channels) you use: ____________________________________________________
Years of flying experience:
_________________________________________________________
Submit
this application, a photocopy of your AMA card, and a personal check for club
dues made out to ASRCC:
Richard Bonnardel
ASRCC Treasurer