BAMApp

Bend Aero Modelers

AMA Chartered Club #2311
Bend, Oregon

Membership Application 2010

First Name _________________________ Last Name_______________________________

Street________________________________________________________ Apt___________

City__________________________ State______________________ Zip______________

Birth date____________________ Telephone_________________ *AMA#_____________

Email__________________________________ Radio Equip Brand used _________________

Radio Freq. Channels _________________________________

** Please Attach a Photostat (Copy) of your AMA Card if mailing your application.

*Please Note that AMA Membership and License required for insurance purposes

Initiation Fees:

Regular Membership ** $10.00 (Per Household)
**Youth Membership (under 17) Fee Waived

Annual Dues:

Individual $50..00
Family (Per Household) $65.00
Individual Youth (under 17) $25.00 Initiation Fee Waived

Please Make your Checks Payable to BAM and Forward to : Dan Clark, Treasurer Bend Aero Modelers 16126 Elkhorn Lane
La Pine, OR 97739-9797 Bend Aero Modelers is a State of Oregon Non-Profit Organization: