Information on MASA membership
To join MASA as a new member, or to renew your 2009 membership, please print
out and fill in this form, enclose a check for dues, and mail it to the address
at the bottom of the application. Membership forms and dues may also be
given to the Secretary/Treasurer at MASA meetings or launches (if he is
present.)
(Please make checks payable to Jason Colt. Do NOT make checks
out to "MASA"!)
New or renewal? Please select one:
| New Membership (Welcome!) | |
| Membership Renewal |
| First Name: | ||
| Last Name: | ||
| If you are renewing your membership, you only need to fill out the rest of this section if something has changed from last year. | ||
| Street Address: |
||
| City, State: | ||
| ZIP Code: | ||
| Home Phone #: | ||
| Other Phone #: | ||
| Email Address: | ||
| Web Site Address: | ||
| NAR #: | HPR Cert Level? | |
| TRA #: | HPR Cert Level? | |
Have you achieved a NARTREK level? (please circle) BRONZE
SILVER GOLD
(If you have no idea what that means, don't worry about it.)
Newsletter delivery method, please select one:
| Newsletter Delivery | Fee | |
|---|---|---|
| Mail it to me (regular US mail) There is an additional fee to help cover printing & postage costs. | $6.00 | |
| Don't mail it; I'll download the PDF file from the MASA web site. | Free! |
Please select your appropriate membership level:
| Membership Type | Dues | |
|---|---|---|
| Individual (18 or older) | $10.00 | |
| Junior Individual (17 or younger) | $5.00 | |
| Family (max 4 people) Please list the names of up to 3 additional immediate family members: |
$12.00 |
Dues are assessed on a calendar year, January to December, basis.
New members, we would appreciate it if you could answer the following
questions so that we can provide the best rocketry experience possible.
How long have you been flying rockets?
Circle your most commonly used engine sizes.
A B C D E F G H I J
K K+
What rocketry topics would you like to see presented during monthly meetings?
Will you be able to assist with organization of club activities and launches?
Additional Comments:
Please send this form by regular US mail along with a check (no cash please) for
your dues & fees to :
MASA / Jason Colt
1803 Fulham St.
Lauderdale, MN 55113
(Please make checks payable to Jason Colt. Do NOT make checks
out to "MASA"!)
Thank you!