MICHIGAN KNIGHTS OF THE HIGHWAY, INC.
                                MEMBERSHIP / RENEWAL APPLICATION
                              (Information will be used for the next directory.)

MAKE CHECKS PAYABLE TO:  MICHIGAN KNIGHTS OF THE HIGHWAY
                                        MAIL TO:
          Donald DuCharme
                                                                    7894 Kingsbury Rd
                                                                    Delton MI 49046-8601

Applicants must be members of the Family Motor Coach Association (FMCA).

FMCA # _____________________   Date of Application ___________________
 

r New - $20.00     r On-Time Renewal Before March 31 of Renewal Year - $15.00    
r
Renewal After March 31 of Renewal Year - $20.00    r Extra Years paid ahead - $15.00 / Year

_______________________  _____________________   __________________
            Last Name                              First Name                    Spouse's First Name

___________________________________  ____________________________
                  Home Address                                                            City

________   ___________     ________________     ________________________
   State              Zip Code            Telephone Number                    E-mail Address
_________________________________________________________________
  * SUMMER MAILING ADDRESS (If different from above)
__________________________________  ____________________________
                  Home Address                                                            City

________   ___________     ________________     ________________________
   State              Zip Code            Telephone Number                    E-mail Address

_________________________________________________________________
  * WINTER MAILING ADDRESS (If different from above)

__________________________________  ____________________________
                  Home Address                                                            City

________   ___________     ________________     ________________________
   State              Zip Code            Telephone Number                    E-mail Address
Dates for Winter Mailing:  Start ________________  Thru ____________________

NEW members are entitled to (2) identification badges.  Please list the names you wish
on them (shortened or nicknames OK) ________________  __________________
                                                                    First Name                    Spouse
The badges will be an oblong/rectangle.

If you wish to order replacement or extra badges for children or guests ($4.00)
 

________________  ________________  _______________   _______________