PORT CITY RC CLUB

           MEMBER APPLICATION 

PERSONAL INFORMATION

NAME____________________________________________________________________

MAILING ADDRESS_______________________________________________________

CITY_________________________STATE_____________ ZIP____________

EMAIL ADDRESS_________________________________________________________

PHONE _________________________________________

MEMBERSHIP INFORMATION

CHECK MEMBERSHIP TYPE

___FULL MEMBERSHIP                $40.00           AMA NUMBER___________________

___ASSOCIATE MEMBERSHIP    $20.00           AMA NUMBER___________________

____________________________Current Club Name (Associate Member's Only)

DO YOU REQUIRE FLIGHT INSTRUCTION             YES_______                 NO_______

(NO CHARGE TO NEW MEMBERS)

FREQUENCY NUMBERS_____________________________________________________

Make checks payable to PORT CITY RC

                                            3360 MEMORIAL DRIVE

                                            MUSKEGON, MI. 49445