Doc No:FMSA0035 Rev:00Copyright(C) Hanmar Motor Corporation 203 L-1ROADTREK INTERNATIONAL CHAPTER FMCAA ROADTREK OWNERS' CLUBPLEASE 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. WE CANNOT PROCESS YOURROADTREKINTERNATIONALCHAPTER APPLICATION UNTIL YOU ARE ANFMCA MEMBER. Mail both forms and checks inseparate envelopes today. FMCA members send only the Roadtrek application form and check.I/We would be interested in helping run the Chapter. ______ Yes ______ NoI/We would be interested in serving as an elected officer. ______ Yes ______ NoPlease enclose $10.00 in U.S. funds,Make check or money order payable to "Roadtrek International."Note: The Chapter cannot accept credit cards.Mail application and fee to: Phyllis Hanson, Chapter Treasurer, 1029 Pleasant Street,Watertown, WI 53098-3020 (920) 261-5827[ Cut and mail in separate envelopes ]FAMILY MOTOR COACH ASSOCIATIONPLEASE PRINT MEMBERSHIP APPLICATION DATE________________Last Name __________________ First Name ________________ Spouse ____________________Address ____________________ City ______________________ Prov/State __________________Country ____________________ Postal/ZIP Code ____________ Phone: ( ) __________________Coach Manufacturer:Home & Park Motorhomes Model:Roadtrek Year:______ Coach Length:______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 here about FMCA?____________________________________Name Member #Return application and fees to: FMCAMembership Chairman, 8291 Clough Pike, Cincinnati, OH 45244-2796. Phone (513) 474-3622I enclose $35 (payable in U.S. funds) for a Family membership.The $35 is composed of $10 initiation fee, $20 for one year'smembership dues, and $5 for one-year subscription to FamilyMotor Coaching Magazine . (Includes coach identificationemblems.) I understand that upon acceptance of my application,I will be sent a copy of the FMCACode of Ethics. I agree to readand abide by this code, which represents all our endeavors tobe good neighbors, careful and responsible coach owners andoperators, and good citizens of our communities.Signed:____________________________________________Make check or money order payable to: FMCA, Inc.Please charge my Mastercard VISA DiscoverCard # ______________________ Exp. Date____________Signature. If charged, must sign here.__________________________________________________Doc No:FMSA0035 Rev:00Copyright(C) Hanmar Motor Corporation 203 L-1ROADTREK INTERNATIONAL CHAPTER FMCAA ROADTREK OWNERS' CLUBPLEASE 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. WE CANNOT PROCESS YOURROADTREKINTERNATIONALCHAPTER APPLICATION UNTIL YOU ARE ANFMCA MEMBER. Mail both forms and checks inseparate envelopes today. FMCA members send only the Roadtrek application form and check.I/We would be interested in helping run the Chapter. ______ Yes ______ NoI/We would be interested in serving as an elected officer. ______ Yes ______ NoPlease enclose $10.00 in U.S. funds,Make check or money order payable to "Roadtrek International."Note: The Chapter cannot accept credit cards.Mail application and fee to: Phyllis Hanson, Chapter Treasurer, 1029 Pleasant Street,Watertown, WI 53098-3020 (920) 261-5827[ Cut and mail in separate envelopes ]FAMILY MOTOR COACH ASSOCIATIONPLEASE PRINT MEMBERSHIP APPLICATION DATE________________Last Name __________________ First Name ________________ Spouse ____________________Address ____________________ City ______________________ Prov/State __________________Country ____________________ Postal/ZIP Code ____________ Phone: ( ) __________________Coach Manufacturer:Home & Park Motorhomes Model:Roadtrek Year:______ Coach Length:______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 here about FMCA?____________________________________Name Member #Return application and fees to: FMCAMembership Chairman, 8291 Clough Pike, Cincinnati, OH 45244-2796. Phone (513) 474-3622I enclose $35 (payable in U.S. funds) for a Family membership.The $35 is composed of $10 initiation fee, $20 for one year'smembership dues, and $5 for one-year subscription to FamilyMotor Coaching Magazine . (Includes coach identificationemblems.) I understand that upon acceptance of my application,I will be sent a copy of the FMCACode of Ethics. I agree to readand abide by this code, which represents all our endeavors tobe good neighbors, careful and responsible coach owners andoperators, and good citizens of our communities.Signed:____________________________________________Make check or money order payable to: FMCA, Inc.Please charge my Mastercard VISA DiscoverCard # ______________________ Exp. Date____________Signature. If charged, must sign here.__________________________________________________
