Membership Application

Please fill out the information form below. After you submit the form, you will be taken to a page where you will have the option to pay your membership dues ($25 USD) via PayPal or personal check. Thank you and welcome aboard!

Type of application New Renew    
Last name(s) First name(s)
Address City, ST Zip
Email (primary) Email (alternate)
Telephone (Home)    
       
Boat name Boat hull #
Marina name Marina City, ST
Marina Country Telephone (Boat)
Purchase date Purchase type New     Prev own
Keel Wing     Fin    
Berths 2            3    
List in Directory Yes        No    
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