FALCON CLUB OF AMERICA
______________________________________________________________
APPLICATION FOR
MEMBERSHIP
WHEAT STATE Chapter
of the FALCON CLUB of AMERICA
The Falcon Club of America is a non-profit club that was founded in 1979. The
club is an international club of more than 3000 members. The club is for individuals
or families that are interested in the restoration of the Ford Falcon automobiles that were manufactured from 1960 to 1970.
The Wheat State Chapter is a chapter of the Falcon Club of America and is chartered to serve the Falcon owners in the
Wichita & South Central Kansas area. The Chapter is a non-profit club, registered
with the Newton, Ks. Chamber of Commerce to function as a car club hosted out of Newton.
This Chapter is a family oriented club that provides much enjoyment for the members along with the emphasis upon the
Falcon. There are yearly dues and a chapter newsletter that is published every
other month (odd). Meetings are scheduled regularly with one meeting every other
month (even) and one car show per year. The meetings are held in different locations
throughout the area offering opportunities for all members to attend.
Please Print:
NAME:___________________________________
Home Phone:_____________ (listed/Unlisted)
Birthday (Month&Day ):____________________
Address:_________________________________
Work Phone:________________
City:____________________State:____________
Zip Code:______________
E-mail Address:____________________________
Spouse / Significant other name:______________
Birthday (Month & Day):__________
Anniversary Date:___________
Children(s) Name(s)________________________________________________
Falcon(s) Owned:__________________________
Other Car(s) &/or nterest:_____________________
National Dues: $25.00 + Chapter Dues:$20.00= Total: $45.00
Make checks payable to : Wheat State Chapter FCA. Any questions:316-838-7487 Cliff
Club use only_____Packet sent_______
Dues to Treasurer________Added to Roster____