PLEASE PRINT OR TYPE DATE: __________________
APPLICANTS NAME _________________________________________________________
(LAST, FIRST, INITIAL)
FIRST NAME OF SPOUSE _________________________
STREET ADDRESS________________________________________________________
________________________________________________________________
P.O. BOX, CITY, STATE, ZIP (ALL 9#)
_____________ _____________ __________
__________ SERVICE BRANCH STATUS(Active, Retired, Associate) SMART NUMBER
____________________ __________________ ____________ YOUR Birthday M/D SPOUSE'S B-day M/D Anniversary M/D
SPOUSE'S B-day M/D Anniversary M/D (_____)__________________ ( ) ________________ ____________________
TELEPHONE NUMBER(H) TELEPHONE NUMBER (C) E-MAIL ADDRESS
(H) TELEPHONE NUMBER (C) E-MAIL ADDRESS __________ _________Ft. _________ __________
TYPE OF RV LENGTH SLIDE (YorN) HANDICAP? (Y/N)
LENGTH SLIDE (YorN) HANDICAP? (Y/N) Motor home / Trailer /5th Wheel/ etc .
I AGREE TO PARTICIPATE IN CHAPTER ACTIVITIES:
_______________________________
SIGNATURE
ANNUAL DUES $15.00 For Jan.1-Dec.31; $7.50 for Jul.1-Dec.31 (New Members). Dues payable 1 Dec. Delinquent 1 Jan. Make checks payable to DIEGO CRUISERS and mail to:
Donald L. Skidmore
1285 Palomino Road Fallbrook, CA 92028 TREASURER______________________________
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Nametags: T.B.D.
