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MAILING ADDRESS:

                              City: State: Zip:

Phone Number:

E-Mail Address:

Winter Address (If Applicable):

Dates to use winter address:

Motorhome Make: Year: Length:

Please select one of the following three options:
I (We) are presently members of FMCA       Our F or L number is:

I (We) plan to join FMCA        Application form sent to FMCA on:

I (We) would like to be Non Voting Associate member and receive newsletter: (Yes)/(No):

Annual Chapter membership is $10.00 per family. (Renewable each January 1.)

Make check payable to  Superior People  and mail to Chapter Treasurer: