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FIRETOWER FLYERS
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MEMBERSHIP APPLICATION
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 Please Print 20____
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Firetower Flyers renewal membership fees are due as of October 1st of each year. Renewal fees must be received prior to November 31st .After Jan. 31st you will be dropped from the roster. Official Use only
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List radio frequencies you operate by channel number.
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Applicant Information:Date:________________ (MM/DD/YYYY)
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Name:AMA Number: #________________________
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Address 1:
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Address 2:
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City, State, ZIP:
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Telephone Number:Date of Birth (for AMA verification) ____/____/____ (MM/DD/YYYY)
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E-Mail ID:
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Check RC Interests: Scale ( ) Giant ( ) Electric ( ) Helicopters ( )
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Types of Membership and Dues per Year- Please Check One:
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Notes:1. All new applications and renewals must have FAA registration number and proof of current AMA membership. Membership dues are due on the first of each October.
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 membership. Membership dues are due on the first of October each year.
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2. New Membership dues paid after October 31st are pro-rated (see chart below).
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Adult Membership-17 years old and over - $125-pro-rated @ $10.00 per month (see below)
$
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Single Junior - 16 year old and under, $30.00-pro-rated @2.50 per month - new members
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Family living at same address-$150.00-pro-rated @ $12.00 per month (see below)
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Out-of-town membership-$75.00-pro-rated @ $6.00 per month (see below) $
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Total
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Please List Family Members Below
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Name:Date of Birth:AMA #
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____/____/____
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Applicant Certification: I agree to abide by the Firetower Flyers Club Rules, By-Laws, and the AMA Safety Code.
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______________________________________________
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Signature of Applicant
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Schedule of Pro-rated Dues
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Oct. Nov. Dec. Jan. Feb. Mar. Apr. May. Jun. Jul. Aug. Sep.
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Junior-Pro-rated @ $2.50 $30 $27.50 $25 $22.50 $20 $17.50 $15 $15 $15 $15 $15 $15
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Adult--Pro-rated @ $10 $125 $115 $105 $95 $85 $75 $65 $65 $65 $65 $65 $65
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Family--Pro-rated @ $12 $150 $138 $126 $114 $102 $90 $75 $75 $75 $75 $75 $75
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OutofTown--Pro-rated @ $6 $75 $69 $63 $57 $51 $45 $40 $40 $40 $40 $40 $40
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New members will serve a three month probationary period and attend at least one club meeting
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unless excused by a member of the board.
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Mail applications with payment to: Firetower Flyers, 5 Sparrow Drive, Williamston, SC 29697
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Dues may be paid via PayPal "Freinds and Family" to kfa911@gmail.com.
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