CHEVROLET 190 - Manual (Page 81)

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.
__________________________________________________
D Do occ N No o:: 21906503 R Re ev v:: 02 Copyright © Hanmar Motor Corporation 2005 L L--1 1