Membership Application

Fill out the form below or click here to download the membership application form.


Membership Application Form
What type of membership?(*)
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* Membership Requirements - Current or previous owner of a Safari motorcoach and current FMCA member. For reinstatement of membership - previous member of Safari International and current FMCA member.
FMCA membership # F:(*)
Please enter your membership number. Example: 1234. DO NOT include an "F." The "F" is already in the field by default.
Pilot's first and last name(*)
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Copilot's first and last name (optional)
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Please provide your primary mailing address information.
Street(*)
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City(*)
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State(*)
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Zip(*)
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Home phone(*)
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Cell phone
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Dates at this address(*)
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E-mail address(*)
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List in Directory?(*)
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Home state if different from mailing address
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Please provide your secondary mailing address information.
Street
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City
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State
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Zip
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Home phone
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Cell phone
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Dates at this address
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E-mail address
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List in Directory?
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Are you a new member?(*)
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Order badges?(*)
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Coach information is required of new members.
Coach manufacturer and model(*)
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Coach year(*)
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Coach length (*)
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Vin No. (last 6 digits only)(*)
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Date purchased(*)
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Number of children under 18(*)
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Full-time RVers(*)
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Retired(*)
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Name Badge (1 per person) - Please type your name as you want it to appear. Badges are $10.00 each.
Name badges (1 per person) are FREE ONLY with your initial 2-year paid new membership or with the first renewal of your initial 1-year paid new membership. Please type your name as you want it to appear.
Please select badge(s):
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Pilot's first name (or nickname) and last name
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Pilot's town and state (optional)
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Copilot's first name (or nickname) and last name (optional)
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Copilot's town and state (optional)
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How did you hear about us?
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(*)
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