SOUTHWESTERN CAMPER RANCHES, INC.
665 Tyrone Road, Silver City,  New Mexico   88061
1-888-563-7275(Park)    Fax 575-388-4727
YES, I want to become a member of Southwestern Camper Ranches
YOUR NAME:

Last______________________________First_________________________Init______

NAME OF SPOUSE OR TRAVEL COMPANION:

Last______________________________First_________________________Init______

YOUR MAILING ADDRESS:

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City_________________________________State_____Zip Code__________________

Phone_____________________________Email (Optional)_______________________
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EMERGENCY CONTACT:
Name___________________________________________________________________

Address_________________________________________________________________

City_________________________________State_____Zip Code__________________

Phone______________________________Relationship__________________________
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I understand my acceptance as a member is dependent upon Board of Directors
approval and that my initial membership fee is $695.00 which includes the first year's
dues of $150.00.  Annual dues are due on the anniversary date of my membership.

APPLICANT(S) SIGNATURE(S)
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Method of Payment:     q Cash     q Check      q Money Order

Mail Application to Address at top of Page

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