ATC New Member Application Form

Click Here For Help On How To Fill Out The Member Information

1 Year $52.00 (U.S. dollars) 2 Year $80.00 (U.S. dollars)
(above fees include a one-time initiation fee of $15.00)

Last Name: First Name:
Last Name: First Name:
1st Line of Address:
2nd Line of Address:
City: State:   Zip Code:
 
Phone: Cell Phone:
 
1st E-Mail Address:
2nd E-Mail Address:
 
Click Here For Help On How To Fill Out The Unit Information
 
I/We own the following recreational vehicle manufactured by Western RV, Inc.
Type Of Unit:
Year: Model:
Last 5 digits of Serial #: Length: # of Slides:

Were you referred by an Alpenlite Travel Club member? Yes No
If YES, please share their Name and ATC Number.
Name:   ATC Number:

Please add any Comments!

ATC New Member Application Form

Create Membership For:  
 
First Person's Name:  
Second Person's Name:  
Address Line 1:  
Address Line 2:  
City, State and Zip/Postal Code:  
 
Home Phone:  
Cell Phone:  
First E-Mail Address:  
Second E-Mail Address:  
 
Rig Type:  
Serial Number:  
Length:  
No. of Slides:  
Model Year:  
Model Name:  
 
Referred By:  
ATC No:  
Comments:  
Submittal Date:  
  1. Select the Check Data button below to verify the information entered on the form.
    If all necessary information is entered and correct,
  2. Select the Print Form button to print one copy for yourself.
  3. Select the Print Form button again to print one copy of this form to send with your check.
    Make a SEPARATE check out for this request.
  4. Select the SUBMIT button to e-mail the information to the Alpenlite Travel Club Membership Committee.

Signature __________________________________________________________________
Dues are subject to change without notice and are non-refundable.

Please make check payable to Alpenlite Travel Club and mail along with this
signed form to the ATC Membership Committee, PO Box 1726, Clackamas, OR 97015

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _Please do not write below this line _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
For office use only
ATC # assigned____________ Notes________________________________

Date ____________________ Expiration date ____________________