Kennebec Valley Model Aviators
AMA Charter #3804
Membership/Renewal Application

Updated May 5, 2017

Name:
Date of Birth (Youth Only):
Street Address:

Town/City:
State:                        Zip:
Telephone:
Email Address:
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.  **

Member Signature: ___________________________________________     (Parent/Guardian signature required if under 18 years.___________________________________________)

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:

Steve Symonds, KVMA Treasurer
668 Augusta Rd.
Belgrade, ME 04917

Email Address: symondsllc@roadrunner.com

Dues:  Regular \\$70, Senior $65 (65 & over)
Family (same household) \\$90
Youth (under 16) Free

Welcome to the Kennebec Valley Model Aviators!