Please
fill in the blanks and return with your dues to the address below.
Also, if you have one, please
enclose or e-mail a digital photo of you and your motorcoach for our profile
book.
We look forward to enjoying a
rally with you soon. Thank you and welcome to our chapter!
FMCA
#:_________________(Must be a member in good standing with FMCA International)
Name(s):___________________________________________________________________________
(This is how your names will appear on your name tags so please print
clearly)
Address:___________________________________________________________________________
City:_____________________________________State:__________________ZIP:______________
Telephone
_________________________
Cell
Phone:(optional) His:___________________ Hers:___________________
E-Mail
address ___________________________________________
Birthday:
(example 4-15 and 1-12) (His)_____________(Hers)______________
Anniversary:
(example 6-20-65) ___________________
Number
of Children:__________________Number of Grandchildren:________________
Native
State: (His)_________________________(Hers)________________________
Retired:
(His)_________________________________
(Hers) _____________________________
Hobbies:
(His)____________________________________________________________________
(Hers)____________________________________________________________________
Make,
Model, Length & Year of Motorhome:__________________________________________
CB
Handle: (His) ___________________(Hers)____________________
Approximate
year you started RVing?________________________________
Emergency
Contact: __________________________________________________________
Comments____________________________________________________________________
_____________________________________________________________________________
I
enclose $25.00 for the Dues and Chapter Name
Tags. (Annual
Dues $10.00 Name Tags $15.00)
Please
return to: Kansas Twisters
c/o: Janice
Clubine, Secretary
Today’s Date:_____________________
1221 Marlboro
Street
Wichita, KS
67217