Enrollment Form for Membership
1. Contact Information (Only one individual per form.)
□ Mr. □ Ms. □ Mrs. First Name & Initial Last Name
Mailing Address (number and street) Apt.#
City State Zip Code Phone
Date of Birth: Email: □ New Member □ Renewal AMA # (Renewals only - leave blank if unknown)
Recruiter Information: If you were recruited to join AMA by a member, AMA club, or hobby shop, please indicate only one and list the name and AMA number (if known). Recruiter Name: Recruiter AMA #
Primary area of interest (choose only one): □ Radio Control □ Control Line □ Free Flight □ Rocketry □ Multirotor
2. Membership Category
Choose only one of Adult, Park Pilot, Youth, or Affiliate memberships.
All membership categories receive membership, liability and accident/medical insurance, and competitive privileges unless noted.
Adult Memberships
Adult (New & Renewing) - For adults 19 or over as of July 1, 2017. Includes subscription to Model Aviation magazine.
Senior (New & Renewing) - For adults 65 or over as of July 1, 2017. Includes subscription to Model Aviation magazine.
Extra Family - For any adult who resides in the same household as a current Adult Member. Does not include a subscription to Model Aviation magazine.
One-Year Memberships: □ Choose Adult $75.00 □ Choose Senior $65.00 □ Choose Extra Family $38.00
Two-Year Memberships: □ Choose Adult $140.00 □ Choose Senior $120.00 □ Choose Extra Family $70.00
Current Adult Member’s Name and AMA #
Included Magazine Options: Adult and Senior memberships include a subscription to Model Aviation magazine.
Choose magazine delivery method: □ Print □ Digital □ Both ($9.95) □ Print □ Digital □ Both ($19.90)
You may choose to receive your print magazine in a protective plastic wrap. □ Protective wrap ($4.00) □ Protective wrap ($8.00)
Extras: You may add a subscription to Park Pilot magazine, a quarterly publication covering small-field and indoor electric aircraft.
□ Print (1-Year) $9.95 □ Print (2-Year) $19.90 □ Add Free Digital Edition (Print subscription required)
You may subscribe to one or two years of Park Pilot magazine regardless of the length of your Adult membership. You may choose to receive your print magazine in a protective plastic wrap. □ Protective wrap (1 Year) $2.00 □ Protective wrap (2 Year) $4.00
Membership option amt: Magazine amt: Extras amt: Total:
STOP. Adult membership enrollment complete. Go to section #3.
Park Pilot
Park Pilot (New & Renewing) - For adults 19 or over as of July 1, 2017. Includes subscription to Park Pilot magazine.
Park Pilot membership is for aircraft 2 pounds or less that fly below 60 mph and does not include voting rights or competitive privileges. Park Pilot membership benefits are limited to $10,000 of liability coverage.
□ Choose Park Pilot $38.00 □ Choose Park Pilot $70.00
□ Free Digital Edition
Receive the digital edition of Park Pilot magazine as well as the print edition.
You may choose to receive your magazine in a protective plastic wrap. □ Protective wrap ($2.00) □ Protective wrap ($4.00)
Extras: You may add a subscription to Model Aviation magazine. Model Aviation is the monthly flagship publication of the AMA and offers our most extensive coverage of the hobby.
□ Print (1-Year) $36.00 □ Digital (1-Year) $36.00 □ Both (1-Year) $45.95
□ Print (2-Year) $72.00 □ Digital (2-Year) $72.00 □ Both (2-Year) $91.90
You may subscribe to one or two years of Model Aviation magazine regardless of the length of your Park Pilot membership. You may choose to receive your print magazine in a protective plastic wrap. □ Protective wrap (1 Year) $4.00 □ Protective wrap (2 Year) $8.00
Membership option amt: Magazine amt: Extras amt: Total:
STOP. Park Pilot membership enrollment complete. Go to section #3.
Youth
Free Youth - For children and young adults under 19 as of July 1, 2017. □ Choose Free Youth (FREE)
Extras
Youth extras: Enjoy the entire hobby with a Model Aviation magazine.
□ Print ($15.00) □ Digital ($15.00) □ Print & Digital ($19.95)
Receive your magazine in a protective cover wrap. □ $4.00
Youth extras: Learn about park flying with a Park Pilot magazine.
□ Print ($9.95) □ Add Free Digital Edition (Print subscription required)
Receive your magazine in a protective cover wrap. □ $2.00
STOP. Free Youth membership enrollment complete. Go to section #3.
Affiliate
Affiliate - (For non-U.S. permanent residents)
- Insurance and competitive privileges only while flying in the USA.
You may subscribe to one or two years of the digital edition of Model Aviation magazine regardless of the length of your Affiliate membership.
□ Choose Affiliate $36.00 □ Choose Affiliate $68.00
□ Digital (1-Year) $36.00 □ Digital (2-Year) $72.00
Membership option amt: Total:
STOP. Affiliate membership enrollment complete. Go to section #3.
3. Support the AMA Foundation
Scholarship Fund □ $25 □ $50 □ $100 □ Other: $
AMA Site Development □ $25 □ $50 □ $100 □ Other: $
Club Support □ $25 □ $50 □ $100 □ Other: $
General Fund □ $25 □ $50 □ $100 □ Other: $
Museum Patron Program □ $75 Patron □ $100 Supporting □ $1,000 / Life
Donation Total:
4. Payment
□ Check □ Visa □ Mastercard □ Discover Card No. Exp:
All membership benefits begin on the day a properly completed form and correct dues payment is received at AMA Headquarters. If a magazine is included with the membership, it begins with the first issue available for the year after a correct form and payment are received. Membership rates and insurance limits are subject to change. Actual cost of dues and amount of insurance coverage are subject to change. Any such changes will be noted at the time of membership processing so they may be accepted or not.
If I am involved in any claim or suit I will not sue the AMA, Inc. I understand that this does not affect my liability insurance coverage. “I agree to comply with the AMA Safety Code.”
Signature:
Enrollment Total: $ Application Source: M
Questions?
For help completing this form, contact AMA at (800) 435-9262.
www.modelaircraft.org
Return completed form to
Academy of Model Aeronautics
5161 E. Memorial Dr.
Muncie IN 47302
Or fax your form to: (765) 741-0057.
