Santa Barbara Radio Control Modelers
			P.O. Box 6571
			Santa Barbara, CA  93160
			Membership Application
Name:	____________________________________________					Phone:	Home ______________
Address: __________________________________________							Work _______________
City: _______________________________				Zip: __________			Cell ________________
Email Address: _____________________________________							Birthdate: ___________
AMA Number:		_______________		Radio Channels: _____ _____ _____ _____ _____
Names of family members (under 18) to be included in your adult membership:
_________________________			_________________________			_________________________
Spouse	_________________________
Aircraft interests:		Nitro ____  Electric _____  Sport Planes _____ Warbirds _____
(check all that apply)
		Gliders _____  Helis _____  Aerobatics _____ Racing _____
I wish to receive flight instruction:  Yes _____  No _____
Amount Remitted:		Dues ($50 for adult, $25 for youth under 18)						________
		Runway Assessment ($50 for adult, $0 for youth)						________
		(first year only)
		Total						________
First Year’s Dues Waived:  ______________________________________________
			Signature of hobby shop owner / date
Dues Waiver:		First year’s dues are waived if applicant has purchased a radio, airplane and
		engine/motor from any local hobby shop.
Note to Applicant:		Please send AMA application directly to AMA