ROADTREK INTERNATIONAL CHAPTER FMCA
A ROADTREK OWNERS’ CLUB
Please Print
MEMBERSHIP APPLICATION
Date
______________
Last Name __________________
First Name ________________
Spouse ____________________
Address ____________________
City ______________________
Prov/State __________________
Country ____________________
Postal/ZIP Code ____________
Phone: ( ) __________________
FMCA# ________________ If you are not currently a member of the Family Motor Coach Association,
please complete the FMCA Membership Application Form below.
W
E CANNOT PROCESS YOUR
R
OADTREK
I
NTERNATIONAL
C
HAPTER APPLICATION UNTIL YOU ARE AN
FMCA
MEMBER
. Mail both forms and checks in
separate envelopes today. FMCA members send only the Roadtrek application form and check.
I/We would be interested in helping run the Chapter.
______ Yes
______ No
I/We would be interested in serving as an elected officer.
______ Yes
______ No
Please enclose $10.00 in U.S. funds.
Note:
The Chapter cannot accept credit cards.
Make check or money order payable to
“Roadtrek International”
.
Mail application and fee to: Becky Hartley, Chapter Treasurer, Email: [email protected]
231 W. Washington St. Nelsonville, OH 45764-1138 Telephone: (740) 753-1066
[ Cut and mail in separate envelopes ]
FAMILY MOTOR COACH ASSOCIATION
Please Print
MEMBERSHIP APPLICATION
Date
________________
Last Name __________________
First Name ________________
Spouse ____________________
Address ____________________
City ______________________
Prov/State __________________
Country ____________________
Postal/ZIP Code ____________
Phone: ( ) ______________
E-mail Address
______________
Coach Manufacturer:
Home & Park Motorhomes
Model:
______
Roadtrek
Year:
_______
Length:
________
License Plate Number:
__________________
I have applied for membership in the
Roadtrek International Chapter
of the Family Motor Coach Association.
( ) If you are a former member, check here.
____________________________________
Occupation or former occupation, if retired.
How did you hear about FMCA?
____________________________________
If referred by an FMCA member, please list
his/her name and member number
Return application and fees to: FMCA Membership Chairman, 8291 Clough Pike, Cincinnati, OH 45244-2796. Telephone (513) 474-3622
I enclose $45, (payable in U.S. funds) for a Full/Family
membership, (includes membership identification emblems.).
The $45 is composed of a $10 initiation fee, $30 for one year’s
membership fee, and $5 for a one-year subscription to
Family
Motor Coaching
magazine. I understand that upon acceptance
of my application, I will be sent a copy of the FMCA Code of
Ethics. I agree to read and abide by this code, which represents
all our endeavors to be good neighbors, careful and responsible
coach owners and operators, and good citizens of our
communities.
Signed:____________________________________________
Make check or money order payable to: FMCA, Inc.
Please charge my
Mastercard VISA
Discover American Express
Card #
______________________ Exp. Date ____________
Signature. If charged, must sign here.
__________________________________________________
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