Membership Application

Please print the form, complete it and mail to Liana Kinne

All fields are not necessary and under no circumstances will we ever sell or distribute our database to any third party vendor without the permission of the membership. Since we operate this club on a shoestring we would ask that all our members use e-mail as much as possible to communicate. There is a $5.00 per coach membership fee which you can mail to us at the following address along with this form.  Thanks and welcome to our group!!

Please make your check out to Liana Kinne

Liana Kinne
8795 N. Valley Oak Drive
Prescott, Arizona  86305

First Name                 

Co-Pilot First Name   

Last Name(s)           

Street Address         

City                        

State                      

Zip Code               

FMCA Membership Number

Home Phone/Cell Phone             

E-mail Address            VERY IMPORTANT

Please provide us information on your TREK:

Year                 

Model                  

Diesel or Gas