Number ___________
Tripoli Oklahoma Attn: Larry Ortega 2401 Tee Circle, Suite 202, Norman, OK  73069
Prefecture #18 of the Tripoli Rocketry Association, Inc.

MEMBERSHIP APPLICATION

NAME___________________________________________ TRA # _______
ADDRESS______________________________________________________
CITY______________________________STATE________ZIP__________
HOME PHONE_____________________E-MAIL ____________________
OCCUPATION____________________________________AGE_________
DATE CONFIRMED__________________CONFIRMATION LEVEL___
CONFIRMED BY_______________________________________________

Areas of Interest

___ Design ---------------------------------- ___ Construction -------------------------- ___ Payloads
___ Motors ----------------------------------___ Research -------------------------------- ___ Ground Support
___ Photography -------------------------- ___ Electronics ---------------------------- ___ Altitude
___ Competition --------------------------- ___ Mechanical --------------------------- ___ High Power
___ Computer ------------------------------ ___ Tracking ------------------------------- ___ Writing

Membership Class

___ SENIOR (21 and older) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ $24.00
___ JUNIOR (20 and under)_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ $12.00
___ OUT OF STATE _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ $12.00
___ FULL TIME STUDENT _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ $12.00
Amount prorated by $2/month, renewal in Nov. (Check or money order only - NO CASH)

I understand that Tripoli Oklahoma is not able to assume any liability
of any kind with regard to my activities, or the activities of others.
I agree to pursue my advanced rocketry activities in
compliance with the association's bylaws and safety code,
and that I will be an active member of the association
to the best of my ability.

Date __________________ Signature ________________________________

Guardian's Signature if under 21 ________________________________