SOUTHEAST COUNTRY COACHERS
An affiliate of Family Motor
Coach Association
Our preference is that you pay via PayPal and mail the membership info. However, you may enclose payment of $50.00 ($15 application fee plus $35 membership fee) with your application. You DO NOT have to have a PayPal account. You may pay with Visa, Master Card, Discover, or American Express.
Our preference is that you pay via PayPal and mail the membership info. However, you may enclose payment of $50.00 ($15 application fee plus $35 membership fee) with your application. You DO NOT have to have a PayPal account. You may pay with Visa, Master Card, Discover, or American Express.
New Members
Please Print, fill in and mail:
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:
Tammy Toalson
8430 Kingswood Rd
Panama City, FL 32409
