Muncy Indoor Flyers

Membership Application

Check Membership Level:

Full Member ($25) ______ Student ($12.50) ______ Associate ($10) ________

Full members have voting and flying privileges. Student membership is limited to those that are full time students under age 24. They have same privilieges as full members but may not hold offices. Associate members may vote but cannot hold office or fly at club activities.

First Name: _______________________________ M. I. ____________

Last Name: _______________________________ Suffix: __________

Street Address: ________________________________________________

________________________________________________

City: _______________________________ State: ___________

Zip: ________________________________________________

Home Phone: Area Code: _______ Number: _______________________

E-Mail: ________________________________________________

TX Channels: ________________________________________________

Please note that Channels 33 and 34 are believed to be unusable within the STN Sports Dome due to major interference issues.

AMA Number: ________________________________________________

Optional Information:

Work Phone: Area Code: _______ Number: _______________________

Spouse's Name: ________________________________________________

Return Application To: Ron Angle, 428 East Lamb Street, Bellefonte, PA 16823