Black Sheep RC Club, Inc.
2008 Membership Application
Please make sure that your handwriting is legible for documentation purposes.
USE THIS APPLICATION FOR ONE INDIVIDUAL ONLY
OTHER FAMILY MEMBER (S) FILL OUT A SEPARATE FORM (S) AND ATTACH FOR THE FAMILY MEMBERSHIP
This application is for RENEWAL or NEW MEMBER (circle one)
Today’s Date: ____/_____/_______
Name: ________________________________________________________Date of birth_____/_____/______
Address: __________________________________________________________________________________
City: _______________________________________________________ State: ______ ZIP Code: _________
Home Phone: (______)_______________________ Work Phone: (_______)___________________________
E-Mail:____________________@___________________Would you like your newsletter? E-Mail or US Mail
AMA Number: __________________________Flying freq. most used: ____________________________________
Please enclose a copy of your current AMA card. Must be a current AMA member to fly at the field.
MEMBERSHIP AND FEES:
PLEASE CHECK ONE BELOW
CLASS DUES
q JUNIOR $30.00 yr.
q ADULT $60.00 yr.
q FAMILY $90.00 yr.
q SENIOR $30.00 yr.
q DISABLED $30.00 yr.
q ADDITIONAL FAMILY MEMBER(s)-Submit information on a separate sheet(s) and attach
q Initiation Fee (new members) $50.00 (one time)
New members shall pay the $50 initiation fee and include a copy of their current AMA card with their application.
To submit application
 | Provide application & appropriate dues payment in person to any club officer and verify |
AMA status to him.
OR
| Mail the application along with appropriate payment and a copy of current AMA card to: |
Nelson Swords
228 Ellison Lake Rd
Williamston, SC 29697
SAFETY DECLARATION (All members must sign annually)
Applicant Certification: I agree to abide by the BSRCC rules, By Laws, and AMA Safety Code
________________________________________
Applicant Signature