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Application

To apply for membership to the Midland RC Club please fill out the application and bring to our monthly meeting see the calendar for details.

MIDLAND RC MODELERS CLUB
MEMBERSHIP APPLICATION/RENEWAL


MEMBERSHIP YEAR:__________

TYPE OF MEMBERSHIP:
REGULAR (AGE 18 & OVER):________
FAMILY MEMBER:______
JUNIOR (UNDER AGE 18):______
SENIOR (AGE 65 & OVER):______
ASSOCIATE:______

IS THIS A RENEWAL OF YOUR MRCM CLUB MEMBERSHIP? YES_______ NO_______

IS THIS A CHANGE IN YOUR MRCM CLUB MEMBERSHIP CATEGORY? YES_____ NO_____

NAME:_______________________________________PHONE NR._______________

ADDRESS:__________________________________________
CITY:_____________________

STATE:______ ZIP CODE:__________ AGE:__________
SPOUSE NAME:____________________

E-MAIL ADDRESS__________________________

A.M.A. NR:________________________
A.M.A. CARD EXPIRATION DATE:_____________

R/C INTERESTS?