Woodland/Davis Aeromodelers, Inc. 2012 Membership Form    http://www.wdarc.org
ADULT MEMBER OR GUARDIAN
Name:       
Street:   		            City:   		      State:          Zip:  
Home Phone:   		
Alt Phone:   				Email Address:
  
 (   )  List my name only on club roster 	

Club Newsletter (Check One)
(   )  I wish to receive a hardcopy of the club newsletter
(   )  I'll read the online version of the club newsletter

RETURNING MEMBERS

2012 AMA Number:       		2011 Points Earned:  ______________
2011 Points Purchased: ________ X($16.66/point) = $ _________(6pts./year required)
2012 Payment:(___) Junior $16.00 (___) Adult 18-55 $65.00(___) Senior 55-75 $60.00  (___) Super Senior 75 & older 60.00 (___) Family $81.00
Total Payment: $ _________    Check No. _______       2012 Combo _______

NEW MEMBERS

(Payment made from 1/1 to 8/31 Full Amount, 9/1 to 11/30 50%, 12/1 to 12/31 Full Amount and Applied to the Following Year
2012 AMA Number: ________   New Member ______   
2012 Payment:(___) Junior $16.00 (___) Adult 18-55 $65.00(___) Senior 55-75 $60.00  (___) Super Senior 75 & older 60.00 (___) Family $81.00
Total Payment: $ _________    Check No. _______       2012 Combo _______

Mail membership application, check payable to "WOODLAND/DAVIS AEROMODELERS, INC.", 
self-addressed stamped envelope, and proof of AMA membership (either a copy of your AMA card or FAX from the AMA). 

For inquires e-mail Monty Pate at  montypate@sbcglobal.net   or write to the below address.

WDA, Inc.
c/o Monty Pate
144 Clover St.
Woodland, CA.  95695
	
Junior Members
(Each Member Must have a current AMA No. Print Additional Names and AMA Numbers on the Back)
1. Name: ____________________________  AMA No. ___________________
2. Name: ____________________________  AMA No. ___________________

I have read, understand and agree to abide by the AMA Model Safety Code, Woodland/Davis Aeromodelers Current Bylaws and Field Operating Rules and Regulations.


Signature ___________________________________ Date__________________


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OFFICE USE ONLY 
Dues Received: _____ Card Issued: _____ Newsletter Editor Notified_______