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Application for

New MembershipRenewal of Membership

Full Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

E-mail

Phone Number

Area CodePhone Number

List memberships you have in other clubs:

IPMS / USA Membership Number

List your current modeling interests:

What classification of Modeler are you:

JuniorNoviceAdvancedMaster

Your Signature: (By signing, you agree to abide by the rules and regulations of the Constitution and Bylaws of IPMSOC)

All memberships are PRO-RATED for the calendar year, January through December. Therefore, depending on when you join, the following pro-rated schedule will be used: $22 (If you join in Jan - Mar), $20 (Apr - Jun), $15 (Jul - Sep), $10 (Oct-Dec).

PLEASE NOTE THAT THERE IS ALSO A $5.00 DUES THAT ALL MEMBERS PAY EACH TIME THEY ATTEND A MONTHLY MEETING. THIS DUES IS SEPARATE FROM THE MEMBERSHIP FEE AND IS ONLY PAID ON THE NIGHTS THAT YOU ACTUALLY ATTEND A CLUB MEETING.

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Membership fees$22.00

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