Atlantic Society of Radio Control Modellers

Membership Application 2015

Membership Information

Membership Type:

Status Of Membership:

MAAC Number:

Flying Status:

Last Name:

First Name:




Postal Code:

Phone Numbers:




Email Address:

Please indicate what personal information can be posted on the ASRCM web site:

Email Address:

Home Phone:

Work Phone:

Mobile Phone:

Please tell us of any special interest you have in our hobby, or suggest how we can make our Club/Hobby more enjoyable or safer.

By joining the Atlantic Society of Radio Control Modellers Club, I have read and understood the Rules and Regulations for ASRCM and agree to abide by these Rules and Regulations of our Club as well as the MAAC Safety, Etiquette Codes, and Field Operations.

Signature: ____________________________________________

Date: ______________

--------------------------------- Do Not Fill Out Below This Line ----------------------------------

[ ] Valid MAAC Accepted by ___________________________ Date ____________ [ ] Cash [ ] Cheque

--------------------------------------------- Treasurer ---------------------------------------------

Member's Name ____________________________________ Amount: $_________

[ ] Cash

[ ] Cheque #_________ Date __________ Bank ____________________________ Cleared on ____________

[ ] Receipt issued

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