Temp Member

SLO Flyers Declaration

This is to certify that I have read and understand the Cal Poly EFR usage regulations and that I agree to abide by them.  I understand and agree that in any case of discrepancy between Cal Poly. AMA and SLO Flyers Inc. regulations, the more stringent regulation will apply.

Name (please print)________________________

AMA Number____________________________

Signature_______________________________

Date_________________

SLO Flyers, Inc. Term Membership Fee
The following Term memberships are available for AMA members

Over 19 years old

$5.00 for up to one week
$10.00 for up to two weeks
$20.00 for one month
$30 for three months

Under 19 years old

$1.00 for up to one week
$2.00 for up to two weeks
$4.00 for one month
$6.00 for three months

Name (please print)________________________

AMA Number____________________________

Signature_______________________________

Date_________________

Verified by SLO Flyers, Inc. Member

Name (please print)________________________

Sign Name_______________________________

Amount Enclosed_______________________

Expiration Date_________________________

Print this form, complete and mail to:

William K. Lander, Treasurer
P.O. Box 6789
Los Osos, CA 93412-6789

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