FORM - 1001

Please print and fill in as much of the form as you can. Mail to Robert Ness, 3150 N. Royston Road, Potterville, MI. 48876 along with your dues (or give it Bob at the next meeting you attend). Most of the information on this form will not be place on our web site but rather distributed to members of GLASS. In addition, info will be used to help plan events for our club. Dues of $15.00 are payable Jan 1. Make check out to GLASS. Persons joining GLASS after September will be credited for the balance of the year and for the following calendar year.

NAME - (last, first)

ADDRESS - Street City State Zip

HOME PHONE -

AMA # -                                    E-Mail address -

MATE'S NAME -                                              YOUR BIRTH DATE (month/day only)

CHANNEL(S) YOU USE (used for other flyers that may be buying a new radio or changing channels).

Below indicate what events you plan to fly in. Does not have to be perfect. Just general information. Circle those items you fly or are interested in flying.

RES     NOS     2M     UNL     HLG     STD

ELECTRIC GLIDER           ELECTRIC PLANE

Click on red ball to return to the GLASS HOME page

It is not a requirement that you  fill in all the fields