MEMPHIS PROP BUSTERS MEMBERSHIP APPLICATION

First Name______________________ Last Name_____________________________

Address_______________________________________________________________

City____________________________ State______ Zip Code____________________

Home Phone_____________________ Email Address__________________________

Date of Birth____________________

Name (As to appear on your badge)_________________________________________

AMA Membership #__________________

(Please submit a copy of your AMA Card) or Check here if your AMA membership is pending (___)

Skill Level: Novice (__) Intermediate (__ ) Advanced (__ )

Please list all your active channel #�s (23, 41, etc.) _____________________________

I do hereby agree to abide by the rules and regulations of the Memphis Prop Busters, Inc. and the Academy of Model Aeronautics, Inc. including the by-laws of both corporations and all amendments thereto.

Signed _______________________________________ Date ________________

*** Anyone who flies at the Memphis Prop Buster�s field must have a valid AMA membership. All Club and AMA regulations and safety guidelines apply. Memphis Prop Busters or it�s officers are not responsible for injuries, loss, or damages that may occur at the field location or anywhere else.

Dues schedule:

After September 1st the dues are 1/2 the normal price for the remainder of the year

______ Open Membership (18 years of age or older) Annual Dues- $125

______ Senior Membership (65 years of age or older) Annual Dues- $100

______ Junior Membership (under 18 years of age) Annual Dues- $50

______ Family Membership ($125 plus $25 per each additional family member)

Make check payable to: Memphis Prop Busters

Mail to the Treasurer:
Dave Pope
3773 Shirlwood Ave.
Memphis, TN 38122

Last updated: January 2008