Granite Staters Membership Application
No person may become a member of the Granite Staters Chapter unless he/she is a member in good standing of the FMCA (Family Motor Coach Association).
This membership is New ____ Renewal ____ For Information only ____
FMCA # ______________________________________	FMCA Expiration Date _____________________________
Pilot's Last Name _______________________________	Pilot's First name _________________________________
Co-Pilot's Last Name ____________________________	Co-Pilot's First Name ______________________________
Mailing Address ________________________________	City ___________________ State ________ Zip ________
Tel # ________________________________________	E_mail __________________________________
I/we have paid my/our dues or have applied for membership in the FMCA. Enclosed is a check and I/we understand that it is for dues and entitles me/us to membership in good standing in the Granite State Chapter of the FMCA for the period circled below. (no cash please) PLEASE PRINT MATERIAL IN ABOVE SPACES.
Signature __________________________________	Date _____________________
Dues: $15.00 to May 31, 2008
Dues: $65.00 to May 31, 2012
Circle one of the above!

---

Make check payable to GRANITE STATERS
Print this form, fill in the spaces, and
Mail to:	Bobbie and Glenn McCracken - Membership Chairs
	252 Burnham Road
	Freedom NH 03836
	E-mail: bigmac@adelphia.net

To the Granite Staters Home page