Kennebec Valley Model Aviators
AMA Charter #3804
Membership/Renewal
Application
Name:
Date of Birth (Youth Only):
Street Address:
Town/City:
State: Zip:
Telephone:
AMA #:
NOTE: If you do not have your AMA number yet, please indicate the date applied here and report number to Treasurer as soon as
possible:
Date Applied to AMA:
RC Channels You Use:
“I have read and understand the safety rules.”
Signature: ___________________________________________
The newsletter can be downloaded from the web site each month
OR mailed Check One.
Download
Mail
Please print and complete this membership application. Bring the completed application, along with your dues payment, to a KVMA meeting or mail
application and payment to:
Al Hawk, KVMA Treasurer
202 Dutton Road
South
China, ME 04358
Email Address: arhawk@uninet.net
Dues:� First Year \\$50,� Regular \\$50,
Senior $45
Family (same household) \\$70
Youth (under 16) Free, Patron
\\$20
Welcome to the Kennebec Valley Model Aviators!