Adult Membership 3_1

First Name*
Last Name*
Address*
City*
State*
Zip*
Phone Number*
Date of Birth*

MonthDayYear
E-mail*
Current AMA Number or if temporary states so.*
Adult Membership*
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If paid by March 15th$104.12

If paid by April 15th$109.28

If paid on or after April 16th$114.43

If joining on or after August 1st$51.80

If joining on or after October 1st$26.06
Can applicant on this application compently fly RC aircraft. New membership requires a flight test.*

YesNo
I agree/read the by-laws and rules of the Flying Cardinals of Northern Kentucky and the AMA.*

Yes
Additional Comments:
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