Membership Application

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


Membership Application Form
  1. What type of membership?(*)
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    For new membership - 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.
  2. FMCA membership # F:(*)
    Please enter your membership number. Example: 1234. DO NOT include an "F." The "F" is already in the field by default.
  3. Pilot's first and last name(*)
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  4. Copilot's first and last name (optional)
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  5. Please provide your primary mailing address information.
  6. Street(*)
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  7. City(*)
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  8. State(*)
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  9. Zip(*)
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  10. Home phone(*)
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  11. Cell phone
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  12. Dates at this address(*)
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  13. E-mail address(*)
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  14. List in Directory?(*)


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  15. Home state if different from mailing address
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  16. Please provide your secondary mailing address information.
  17. Street
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  18. City
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  19. State
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  20. Zip
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  21. Home phone
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  22. Cell phone
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  23. Dates at this address
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  24. E-mail address
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  25. List in Directory?


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  26.  
  1. Are you a new member?(*)
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  2. Coach manufacturer and model(*)
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  3. Coach year(*)
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  4. Coach length (*)
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  5. Vin No. (last 6 digits only)(*)
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  6. Date purchased(*)
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  7. Number of children under 18(*)
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  8. Full-time RVers(*)


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  9. Retired(*)


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  10. Add on replacement badges?(*)
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  11. Name Badges (1 per person) are FREE for new members. Please type your name as you want it to appear.
  12. Name Badge (1 per person) - Please type your name as you want it to appear. Badges are $8.50 each.
  13. Please select badge(s):(*)
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  14. Pilot's first name (or nickname) and last name(*)
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  15. Pilot's town and state (optional)
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  16. Copilot's first name (or nickname) and last name (optional)
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  17. Copilot's town and state (optional)
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  18. How did you hear about us?
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  19. Type the letters and numbers you see below.(*)
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