Townsville Aeromodellers Society Inc

P.O.Box 535, AITKENVALE 4814

 Membership Application Form

 Surname:        Date:

Full Christian Name/s:

Spouse's Name:

Address:

Post Code:

Email address:

Date of Birth:  (Required from all members).

Pension Number (if applicable):

Phone No. (home): (work):

VH No.(if applicable)

Have you been a member of the MAAQ with any other Club in the last 3 years?

Do you require tuition (or further assistance to fly (Y/N):

Signature of Applicant:

Nominated by:  Seconded by:

NOTE: A MEMBER'S MAAA PUBLIC LIABILITY INSURANCE MUST BE PAID (LICENCE ISSUED) BEFORE HE/SHE MAY FLY AT ANY MODEL AIRFIELD.

UPON SIGNING THIS APPLICATION, THE APPLICANT AGREES TO ABIDE BY THE RULES AND CONSTITUTION OF TOWNSVILLE AEROMODELLERS SOCIETY INC.

OFFICE USE ONLY

Applicant's Status: (Ordinary, Junior, Country)

Club Fee Paid:           Insurance Paid:

Date Joined:           Secretary: