ALOHA STATE RADIO CONTROL CLUB
2011 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 memebers must have individual A.M.A. numbers

Make checks payable to: ASRCC

TOTAL DUES SUBMITTED $___________________

Please submit a photo copy of your 2011 Academy of Model Aeronautics membership card.
I will, as a privileged member of the Aloha State Radio Control Club, fly my aircraft in a manner that is in accordance with the club field rules and the A.M.A. safety code.

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

978 Kahili Street

Kailua, Hawaii 96734