FMCA Covered Wagons
Application for Membership




Please fill in the blanks. Also please enclose or e-mail a digital photograph of you for the pocket directory book which you will receive as part of your dues every year you are a member. (If you don't have a photo - we will take one at your first rally). 

According to our Standing Rules #3:  Prospective members shall attend two regularly scheduled chapter business meetings in a 12-month period.  If they are interested in joining the Chapter, they will submit an application for Membership and then be voted on at the second meeting……If they are accepted for membership, they will submit their annual Chapter dues at that time and receive all Chapter benefits to which they are then entitled.

Thank you and welcome to our chapter!

FMCA #__________________(Must be a member in good standing w/FMCA)

Name(s):______________________________________________________________________
                    (This is how your names will appear on your name tags so please print clearly)


Address:______________________________________________________________________

City
:_____________________________State:______________________ZIP:_____________

Home phone: _______________________________

 

Cell Phone: (optional) His:_________________________   Hers:________________________


E-Mail address: _________________________________

Birthday: (day and month only) (His)____________________(Hers)_______________________

Anniversary: (day, month and year) _____________________Number of Children:________________

Native State: (His)_________________________________(Hers)___________________________

Present or Past Occupation: (His) _________________________ (Hers) _______________________

Hobbies: (His)___________________________________________________________________

             (Hers)___________________________________________________________________

Make, Model, Year & Length of Motorhome:______________________________________________

Approximate year you started RVing: ________________

Pets (breeds and names) traveling with you:________________________________________________

 

Emergency Contact:_______________________________________________________________

Comments:______________________________________________________________

If accepted for Membership in the Covered Wagons, please remit $20.00 dues ($15.00 if you have e-mail available) and add $5.00 per nametag. Make check payable to Covered Wagons.  Thank you!


Return to:            Covered Wagons                                      Date approved:______________________
                          % Bill Keegan

                          3049 SW 45th Street

                          Topeka, KS  66610