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SOUTHEAST COUNTRY COACHERS


An affiliate of Family Motor Coach Association

You may enclose payment of $50.00 ($15 application fee plus $35 membership fee) with your application or mail your application, but pay now with PayPal. You DO NOT have to have a PayPal account. You may pay with Visa, Master Card, Discover, or American Express. 



MEMBERSHIP APPLICATION


*FMCA   MEMBERSHIP #____________________________________*REQUIRED*


NAME____________________________________________________________


PARTNERS NAME___________________________________________________


PRIMARY MAILING ADDRESS__________________________________________


_________________________________________________________________________________________________________


DATES AT THIS ADDRESS____________HOME PHONE______________________


CELL PHONE______________________PARTNER’S CELL____________________


ALTERNATE ADDRESS________________________________________________


DATES AT ALTERNATE ADDRESS________________________________________


EMAIL____________________________________________________________


PARTNER’S EMAIL___________________________________________________

ADDITIONAL INFORMATION

COACH MODEL________________________LENGTH_________YEAR_________

COACH COLORS_____________________________________________________

NAME TAG INFO: names & town, if different from above____________________

__________________________________________________________________

FEES:  MEMBERSHIP FEE OF $15 PLUS ANNUAL DUES OF $35 = $50 FIRST YEAR.

Mail to:
Kent McCoin, Treasurer      
1340 Peninsula Dr  
Prosperity, SC 29127
C: 803-318-0071

Questions?        Email   SEcountrycoachers@gmail.com