APPLICATION FOR MEMBERSHIP

NAME___________________________________ SPOUSE______________________

ADDRESS________________________________ CITY_________________________

STATE_____ ZIP________ PHONE___________ EMAIL_______________________

PLEASE LIST FALCONS OWNED BY YEAR AND BODY STYLE

YEAR____________ BODY STYLE_________________________________________

YEAR____________ BODY STYLE_________________________________________

YEAR____________ BODY STYLE_________________________________________

(Use back of form to list additional Falcons)

WHAT CLUB ACTIVITIES INTEREST YOU

MEETINGS ( ) TOURS ( ) CAR SHOWS ( ) PICNICS ( ) CRUISES-INS ( )

SOCIAL GATHERINGS ( ) OTHER_______________________________________

DUES ARE $15 PER YEAR

MAKE YOUR CHECK PAYABLE TO “VIRGINIA FALCONS” AND SEND TO:

Barbara McCray, Treasurer

The Virginia Falcons Chapter, FCA

7454 Mountain Lily Lane

Mechanicsville, Va 23111

APPLICANT’S SIGNATURE_______________________________________________

FCA MEMBERSHIP NUMBER_____________________________________________