Team-1 Logo Michigan Team-1
Membership Application
Print this form and mail to:

Team-1 Membership
c/o Robert Schultz
6540 Hawthorne
Garden City, MI 48135

Dues are $20.00 per year. Please make checks payable to TEAM-1.
Membership year: ________________________________      New ____  Renewal ____  

Name:       _________________________________________________________________

Address:    _________________________________________________________________

City:       _________________________________________________________________

State:      ________________________            ZIP: ________________________

Home Phone: ________________________     Work Phone: ________________________

Email Addr: _________________________________________________________________

Web Site:   _________________________________________________________________

Birth Date: _________________________________________________________________

TRA #:      ________________________ TRA Cert Level: ________________________

NAR #:      ________________________ NAR Cert Level: ________________________

Most recent cert date: _____________       Location: ________________________

Other Rocket Groups:   ______________________________________________________

I am applying for TRIPOLI Prefecture 9, (MICHIGAN TEAM-1) membership status. I hearby agree to all regulations, safety codes, and rules in effect at TRIPOLI Prefecture 9, (MICHIGAN TEAM-1) events. It is further understood that the purpose and objectives of our group is scientific and recreational. I also agree to hold harmless TRIPOLI Prefecture 9, (MICHIGAN TEAM-1) and TRIPOLI ROCKETRY ASSOCIATION, INC. from any liability of group activity. This will remain in effect until I submit a letter of resignation or my membership is allowed to lapse.

Signed: ___________________________________________   Date: _________________