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Penn Coachmen Chapter of FMCA

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MEMBERSHIP DUES or DIRECTORY PROFILE CHANGE FORM

Although your dues do not expire until December 31st, they must be received by November 30th in order to have your name included in the current year book.

Do not combine rally fees and dues in the same check. Please make check payable to "Penn Coachmen" and mail to the membership Chairperson. If the Membership Chairperson is present at a rally, dues will be accepted at any time during the rally.

Please use this form for New Members, Members Renewing or Members with a Profile change.


FMCA No. -                                                          
 
                                    First Name -           eMail -  
                     Last Name -     2nd eMail - 
Spouse/Friend's Name -  
 
                 Home Phone -              Cell # -             2nd Cell - 

                 Street Address -                      City - 
                Address (cont.) -   State/Province - 
                                                                                                                                                                                                                  Zip/Postal Code - 
 
Winter Address:
                        Address - 
               Address (cont.) -                      City - 
               Address (cont.) -   State/Province - 
                                                                                                                         Zip/Postal Code - 
 
 
New/Renewal/Update -  
 

                 Please check box if you do not want information published in the Penn Coachmen Yearbook Directory.

                       

Print this page after filling the blanks.  Dues: $15.00 per year / 3years $40.00.  Make checks payable to Penn Coachmen and Mail to: Nancy Breisch, 53 Brookfield Dr, Fleetwood, PA 19522. 

Note: You must be a member in good standing of FMCA in order to belong to Penn Coachmen.

Special Categories - (a) Associate members of FMCA retain all member benefits including chapter membership.  They pay chapter dues, but may not vote. - (b) Honorary members are former members who no longer meet criteria for FMCA membership but wish to retain chapter association.  They shall pay chapter dues, may participate in all chapter activities, but may not vote or hold office.