Nutmeg R/C Membership Application

Membership Application


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Please fill out all information


      Name:     (Do not hit return)
     Email:    
    Street:    
      City:     State: Zip: 

     Phone:      Birth Date: 
    
   AMA No.:      Radio Channels:

Please list what kind of airplanes and equipment you have

Membership Type:

Initiation fee:....$25.00 (For new members in addition to regular dues)
Adult...............$35.00
Junior..............$10.00 (Must be under 17 and parent must sign)
Family.............$45.00

Please make checks payable to "Nutmeg R/C Flyers Inc." and send to:

Don Clark-Treasurer
126 Cancellaro Drive
Wolcott, CT 06716

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