MANDALAY TRAVEL CLUB MEMBERSHIP APPLICATION OR RENEWAL

NEW or RENEWAL MEMBERSHIP DUES
_____ $ 15. Membership Dues for Three Years (Jan -- Dec.) --
Pay it & forget it for three yrs.

Please print clearly, especially e-mail address- the MTC communicates mainly by e-mail
therefore it is important to notify us of any changes, especially e-mail address changes!

Name: _________________________________________________ Date:_______________

Co-Pilot’s Name:_________________________________________________________

Address:_____________________________________________________________

City:_____________________________________________  State:________Zip:__________

Phone:  (       ) ________ - ___________ Cell Phone (      )__________ -____________

Email Address:                                      @

FMCA Membership Number: _______________    Expiration Date:__________

Member of Thor Diesel Club:  Yes____  No___      Expiration Date:__________

You must be an active member in good standing with the Family Motor Coach Association (FMCA)               
to be a member of the Mandalay Travel Club and the Thor Diesel Club

Coach Information:

Model Type (Circle One)        Mandalay          Presidio          Valencia

Coach Year:_________ Coach Number (Fill in One)  MDD00______    PDD00_______  VDD00_______

MTC NAME BADGES  are $14.50 each w/shipping (Please allow 4-6 weeks for delivery)
Name: (Exactly as you would like it to appear on the badge)

1) First Name: ______________________________Last Name:_____________________________

2) First Name: ______________________________Last Name:_____________________________

City and State (As you would like it to appear):___________________________________________

To join the Mandalay Travel Club please complete this application and mail with your check (payable in     
U.S. Funds) to Mandalay Travel Club and send to:

                                             
Mandalay Travel Club
                                             
Attn: Ron Horn
                                             6416 West Lake Rd
                                             Clio. MI 48420