Affiliate & Associate Membership Application for New Members & Renewals www.rocketry.org.au Given Name(s): Surname: AMRS Member Number (Renewals only): - If this is a Renewal and there is no change of details, please skip to ‘Application Type’ Address: Date of Birth:__/__/_____ Suburb: Postcode: Nickname/Known As: Gender: Male Female Occupation: Email: Phone(A/H): Phone(Work): Mobile Phone: (name) (phone) Emergency Contact Detail: (relationship) Application Type: New Renewal Affiliate Member Associate Member Affiliate Members receive all AMRS benefits including access to information, invitations to various associated club functions and active participation in rocket launching activities at  $150 sanctioned AMRS launch events. Affiliate members are required to abide by the AMRS Safety Code/s for their rocketry activities. Associate membership, allows members to (where required) purchase rocket motors up to a members certified level and/or state based permissible propellant quantity. Associate members are to abide by the AMRS Safety Code/s for their rocketry activities. Associate  $15 members do not have access to AMRS insurance. Associate members do not have voting rights. Payment Type: Paypal Cheque Cash Direct Deposit I, the under signed, understand that the Australian Model Rocket Society Inc. is not able to assume liability of any kind with regards to my activities or the activities of others. I have read, understand and agree to conduct my rocketry activities in conformance with the Association's Bylaws and Safety Code. Name: Signature: Date:__/__/_____ (If under 18, details of Parent/Guardian required) Please make cheques payable to: Australian Model Rocket Society Inc. Paypal payments can be made to: info@rocketry.org.au Direct deposit details: Australian Model Rocket Society Inc. Commonwealth Bank BSB: 064 793 . ACC: 1004 3978 Please send completed applications (and payment if by cheque) to: PO Box 1233, BROWNS PLAINS QLD 4118, Australia Or scan and email applications to: info@rocketry.org.au PP / CHQ / CASH / DD / Other - $ For Office Use Only – To Be Completed by AMRS Committee Only Date: ____/____/_____ Receipt No: Pack/Card Sent:____/____/______ Australian Model Rocket Society Inc. Membership Application for New Members & Renewals – Ver 1.0 - 06/02/2012