sam_application

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The Society of Antique Modelers
Membership Application

I hereby make application for individual membership in the Society of Antique Modelers.

Name ____________________________________

Age________Years Modeling__________

Phone___________________

Street Address___________________________________________

City______________ State _____ ZIP Code ______________________

What is your area of interest in Vintage Modeling? OT Rubber?___OT Free Flight?____
OT R/C Assist?____Nostalgia? _____

any

AMA No

MECA No.

SAM Chapter____________

In making this application for membership to The Society of Antique Modelers, I agree to abide by the rules set by the Society and realize that the goals of S.A.M. and the Old Timers Movement are to encourage participation above competition and is dedicated to the preservation and reproduction of vintage model aircraft.

Circle One NEW Renewal

Signed__________________________________________

Larry Clark

PO Box 528

Lucerne Valley, CA 92356

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