First Name:*
Last Name:*
Street:*
City:*
State:*
AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
Zip:*
Home Phone:*
Work Phone:
Birth Date:
AMA Number:*
Open: 19 or older as of July 1 Senior: 15 to 18 years old as of July 1 Junior: Under 15 years old as of July 1
Year you first joined RMSA:
RMSA Offices Held:
Are you an AMA CD?
Yes
LSF Number:
LSF Level:
Email Address:
Do you want your newsletter delivered electronically to the above email address? Yes
Non-Flying Family Members:
RMSA Membership Type:*
RMSA Membership Class:*
*I have read and agree to comply with the RMSA Field Rules:
Yes RMSA FIELD RULES
Opt Out
Method of Payment:*
Pay using PAYPAL now!
Leave this empty:
INSTRUCTIONS: Complete all required fields (marked with red *) and press SUBMIT APPLICATION
Membership Cost:
New Member Initiation Fee:
Online Registration Fee:
Total Membership Fee: