2014
NAMBA MEMBERSHIP APPLICATION
THIS FORM MUST BE USED TO APPLY FOR NAMBA INTERNATIONAL MEMBERSHIP
PLEASE NOTE
: Print all information clearly. In the event of an accident, this form becomes a legal form.
Please do not use it for personal notations. Where any doubt of spelling of the name or address occurs, the form
will be returned to the maker, and the membership will be held up. Please keep in mind that the member is not
insured until the request and the fee for insurance have been properly filed with an authorized NAMBA official.
Enclosed please find $
to enroll me in the NAMBA and the Modeler’s Insurance Plan.
NEW MEMBER: _____
EXISTING MEMBER: _____
CURRENT NAMBA #: __________
MEMBERSHIP CATEGORY AND FEES : Adult Member ($45) _____
2
nd
Adult at Same Mailing Address ($35) _____
(Please note: this category does not receive separate mailings)
Junior Under 18 ($25)
NAME: ________________________________________________________________________________
STREET ADDRESS: ___________________________________________________________________
CITY: STATE/PROVINCE: _______________________
COUNTRY: ZIP/POSTAL CODE: _______________________
HOME PHONE NUMBER (Include Area Code): ______________________________________________
CELL PHONE NUMBER (Include Area Code): _______________________________________________
E-MAIL ADDRESS: ______________________________________________________________________
CLUB AFFILIATION (If Applicable): ______________________________________________________
SPECIFIC AREAS OF INTEREST (OUTBOARD, GAS, FE, COMBAT, ETC): _________________
MAIL COMPLETED APPLICATION AND CHECK TO: NAMBA INTERNATIONAL
162 Avenida Chapala
San Marcos, CA 92069
YOU MAY ALSO PAY BY PAYPAL TO EXPEDITE YOUR INSURANCE COVERAGE
PLEASE VISIT THE NAMBA WEB SITE AT
AND CLICK ON THE LINK