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LAKE POWELL
R/C MODELERS
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MEMBERSHIP
APPLICATION
Name____________________________________
Spouse
______________________________ ____
Address(mail)______________________________
Children
__________________________________
(Street)
_______________________________________________________________________________
Phone ____________________________
E-Mail _______________________________________________
Memberships:
(LPRCM, AMA, IMAC, etc,) _____________________________________________________
Organization
Membership
number Paid thru date
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Aviation
Modeling Interests:
R/C.__________
UC
_______ Free flight ______ Old timers ________ Competition
__________
R/C
Proficiency Level:
Not yet
soloed ______ Comfortable at field ______Comfortable with air shows _____ I
fly competition ____
At the
________________________ level in ________________________ events.
I am a
flight instructor in R/C ________ I
will assist with ground school instruction __________________
Training
Needs: Please describe the training you desire to help you enjoy this
sport
______________________________________________________________________________________
______________________________________________________________________________________
LPRCM
annual dues schedule (April-March 31):
Membership
--$40 All memberships include spouse
and dependent children in same household - flying privi-
leges only. One vote per paid membership.
Make
checks payable to Lake Powell R/C Modelers
Please
remember that all members and guests flying at our field must be covered with
insurance from AMA
through an
AMA membership. Forms may be obtained from www.modelaircraft.org or the
club Treasurer,
Tom Zwack
928-660-0834 ThomasEZ@CableOne.net
. When you receive your AMA
membership number,
please
give it to Tom Zwack for our club records
Treasurer Signature__________________ Member Signature
_________________________
