Woodland/Davis Aeromodelers, Inc. 2010 Membership Form http://www.wdarc.org ADULT MEMBER OR GUARDIAN Name: Street: City: State: Zip: Home Phone: Alt Phone: Email Address: ( ) List my name only on club roster Club Newsletter (Check One) ( ) I wish to receive a hardcopy of the club newsletter ( ) I'll read the online version of the club newsletter RETURNING MEMBERS 2010 AMA Number: 2009 Points Earned: ______________ 2009 Points Purchased: ________ X ($25/point) = $ _________(8pts./year required) 2010 Payment: (___) Junior $16.00 (___) Adult $80.00 (___) Senior $75.00 (___) Family $86.00 Total Payment: $ _________ Check No. _______ 2009 Combo _______ NEW MEMBERS (Payment made from 1/1 to 8/31 Full Amount, 9/1 to 11/30 50%, 12/1 to 12/31 Full Amount and Applied to the Following Year) 2010 AMA Number: ________ New Member Initiation Fee: $200.00 ______ (Fee waived for first time AMA members) 2010 Payment:(___) Junior $16.00 (___) Adult $80.00(___) Senior $75.00 (___) Family $86.00 Total Payment: $ _________ Check No. _______ 2009 Combo _______ Mail membership application, check payable to "WOODLAND/DAVIS AEROMODELERS, INC.", self-addressed stamped envelope, and proof of AMA membership (either a copy of your AMA card or FAX from the AMA). For inquires e-mail Randy Sizemore at reddogusa1@aol.com or write to the below address. WDA, Inc. c/o Randy Sizemore 7317 Black Oaks Way Citrus Heights, CA 95621 Junior Members (Each Member Must have a current AMA No. Print Additional Names and AMA Numbers on the Back) 1. Name: ____________________________ AMA No. ___________________ 2. Name: ____________________________ AMA No. ___________________ I have read, understand and agree to abide by the AMA Model Safety Code, Woodland/Davis Aeromodelers Current Bylaws and Field Operating Rules and Regulations. Signature ___________________________________ Date__________________ OFFICE USE ONLY Dues Received: _____ Card Issued: _____ Newsletter Editor Notified _______