Application

METROPOLITAN CHAPTER APPLICATION

No person may be a member of the Metropolitan Chapter of FMCA unless he/she is a member in good standing of FMCA (Family Motor Coach Association).  Application for membership in FMCA may be made simultaneously with application for Metropolitan Chapter. 

Name:
Pilot:  __________________________________  Co-Pilot_____________________________            

FMCA #:  ___________                      Expiration date:  _____________________

 Address:  ____________________________________     City:  ______________________________

State:  _________       Zip:  ____________

Telephone number:  (___)____________Cell phone (optional):  (     )     ______               

E-Mail address: ________________________________

Coach length:  _______    Coach Make:  ____________________________  

Coach Model:  _______________________

Dues are $10.00 annually. 

Please make check payable to Metropolitan Chapter of FMCA  and mail to: 

Jim Kelly   
56 Stuart Rd.
Cortland Manor, NY 10567

New application? ____   Renewal? ____                                             

Signature:  _______________________________________