Polar Bear Grand Tour
2020-2021 Membership
Registration Application

Name
Street
City
State
ZIP
Are you a NEW member? YES NO
Phone
E-Mail
AMA #
Club Name
Current Flight: A B
Join next year's Member of the Week club? YES NO

Please enter any comments you may have:

APPLICATION FEE:
AMA Members $22.00 if paid by September 1st
AMA Members $25.00 if paid after September 1st
Non AMA Members $25.00 if paid by September 1st
Non AMA Members $28.00 if paid after September 1st
Polar Bear Member of the Week fee $20.00

Important: Print out this application and then fill it out. Make all checks payable to: Polar Bear Grand Tour. Mail this completed form along with your check to:

Polar Bear Grand Tour c/o Jim Conway
1 Northumberland Drive
Toms River, NJ 08757-4716


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