RIVANNA RADIO CONTROL CLUB 2015 MEMBERSHIP APPLICATION AND RENEWAL FORM Name: _____________________________________________ Address: __________________________________________ City: _______________ State: ____ Zip Code: ___________ Phone: ___________________________________________ E-mail Address: ____________________________________ AMA#:_________ AMA Renewal Applied for AMA Applied for Frequency or Channel Number: _____________ Membership: Adult Junior Non Flying Dues: $___________ Signature_________________________ Date: ______________ Annual dues should be paid prior to April 1 of each year in order to remain an active member. This Application / Renewal Form must accompany your payment. Please include a copy (if possible) of your current AMA card. Membership cards will be dispersed after May 1 each year. Dues Schedule: Adult: $55.00 annually (pro-rated for NEW Members only, ask for details) Junior: $5.00 (for members under 18) Supporting: $30.00 (non flying member AMA membership not required) All major credit cards & PayPal gladly accepted for an additional $2.00 please contact Shayne Brandon for an invioce at wsbrandon@gmail.com Or Mark Hodges @ (434)326-2416 for more details. Please mail your dues and the completed form to: Shayne Brandon 36 Hawks Rise Lane Palmyra, VA 22963 Only active flying members of RRCC/AMA are permitted to fly at the club field. Exceptions are: AMA members that are guests of an RRCC member. RRCC Members are listed on the field bulletin board. A current AMA Card must be displayed on the frequency board for all pilots operating a transmitter. RRCCDuesAPP Rev: 11.2013DLT