Application Form

GMC Sunshine Statesmen

Chapter of the F.M.C.A.

Application for Membership

This club is dedicated to the preservation of the classic GMC (TZE) Motorhome. It exists to provide a forum for the support and enhancement of these motorhomes.

Membership Requirement:

You must own a titled, registered, and insured GMC Motorhome (with TZE Serial Number), and be (or become) a member of the Family Motor Coach Association.

SEE CONSTITUTION AND BY-LAWS FOR A FULL DESCRIPTION OF THE RULES!

Please COMPLETE the form to assure accuracy in YOUR data. Type or print legibly with a black pen

Last Name: _______________________ First Name: _______________

Spouse/Companion: _________________ Anniversary (M/D): _________

Birthday (M/D) _______________ Spouse Birthday (M/D): ___________

Street Address: ____________________________________________

City: _________________________ State: ___ Zip(+4): ___________

Phone: (_____)_______________ Fax: (_____)_______________

Cell Phone: (_____)_______________

Email: __________________________ FMCA Number: F-___________

GMC Year: ______ Model: ______________ TZE-________________

Summer/Other Address:

Street Address: ____________________________________________

City: _________________________ State: ___ Zip(+4): ___________

Phone: (_____) _______________ Fax: (_____) _______________

Make checks payable ($45.00) to: GMC Sunshine Statesmen

Mail to: Sam Carson (Secretary/Treasurer) One time initiation fee: $25.00