Perfect Circle - Home

Family Name                                          Husband’s Name                                             

Wife’s Name                                             Phone No.                                                       

 Address:                                                                                                                             

 Do hereby make application for membership with the PERFECT CIRCLE CHAPTER  of FAMILY MOTOR COACH  ASSOCIATION And if accepted, do hereby promise to obey the By-laws set up for governing this Chapter. 

Children’s Names and Ages                                                                                                                                    

                                                    _______________________________

 E-Mail                                                                                                                         

 FMCA No                                           Make of Motorhome                                          

 Date:                                                     Signature of Applicant                                      

  Dues Received By:                                          

 Sponsored By:                                               FMCA No#                                        

 Approved By:                                      

 PLEASE FORWARD WITH YOUR ANNUAL DUES TO:

                                                                                              Mrs. Barb Boone

                                                                                                                         Membership Secretary

Make cheques payable to:                                              Perfect Circle Chapter,

PERFECT CIRCLE CHAPTER                                     19 Secoudon Dr.

2011 - 2012  dues = $20.00                                             Saint John, N. B.  E2K 5G3

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ 

To use this order form do a copy & paste into Word or Wordperfect. Then save file to your computer and then input data as required.  Save document and print.  Then send hard copy and check for total to above address.

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++