2008
MID-HUDSON RADIO CONTROL SOCIETY

NEW___________     RENEWAL ___________

Name ____________________________ E Mail Address _________________________ (please print clearly)

Address ___________________________

City _________________ State __________ ZIP _______ County ____________

Home Phone (_____) ________________ AMA # _____________ DOB _______

Radio Channels Utilized _______________________________________________

Signed Off  For Airplane ____ Sailplane ____ Helicopter ____ Not signed Off ____

Areas of Interest   Sport ___ Scale ___ Soaring ___ Electric ___ Helicopter ___

Regular Member: $125.00 those 19 or over by July 1st                                            $ __________

Regular Spouse Member: $ 25.00 (no initiation fee)                                                $ _________

Regular Youth Member: $ 5.00 those 19 or under as of July 1st                               $ _________

Life Member: $ 0.00

Late Fee Assessment: $15.00 if paid after March meeting and by the April              $ _________
meeting. 
Please note that any member failing to meet the April late registration 
deadline will be required to pay an initiation fee as a rejoining member.

Initiation Fee for new or rejoining members: $ 25.00 if over 19 by July 1st              $ _________
                                                                        $   0.00 if under 19 as of July 1st 
                                                                                              Total Dues Due            $ _________

TOTAL COLLECTED: CASH $ ________ CHECK:_________ OTHER:___________

I hereby attest that I have received a current copy of the MHRCS By-Laws and Field Rules. I agree to read and abide by these documents.

Signed _______________________________________________ Date _________________

Note: New membership dues must be paid in person to the Membership Director or his assistant at a regular club meeting. A copy of your 2008 AMA membership card must be provided at this time. If application is mailed you must include a copy of your 2008 AMA membership card and a self addressed stamped envelop.

Return to: Rob Stubbs  
               626 S. Hillside Rd.  
               Wappingers Falls NY 12590
                Phone 845-592-2724   (Please no calls after 7pm)