Membership Application

Personal Details
Legal Name*
First Last
Nickname
Home Address*
Street Address Address Line 2 City State ZIP Code
Home Phone
Cell Phone
Email*
Birth Date*
Month
Day
Year
Retired?*
- Yes
- No
Firm Name
Title / Position
Firm Address
Street Address Address Line 2 City State ZIP Code
Nature of Business
Business Phone
Business Email
I am/have been a member of the following clubs/social/service/charitable organizations (if office, please list):
Hobbies and Interests
Please check all that apply
- I have a spouse/partner
- I have children
- I currently own a boat

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Spouse / Partner
Spouse's / Partner's Legal Name
First Last
Nickname
Do they share the same home address as you?
- Yes
- No
Home Address
Street Address Address Line 2 City State ZIP Code
Home Phone
Cell Phone
Email
Birth Date
Month
Day
Year
Retired?
- Yes
- No
Firm Name
Title/Position
Firm Address
Street Address Address Line 2 City State ZIP Code
Nature of Business
Business Phone
Business Email
Spouse/Partner is/has been a member of the following clubs/social/service/charitable organizations (if office, please list):
Hobbies and Interests

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References
References
Name Address Telephone Email

Please list at least two references
Your Boat
Vessel Name
Manufacturer
Year Vessel Manufactured
Model
Dimensions
Length Beam Draft
Additional Details
Hull Number PHRF Year Acquired
Attach a copy of Documentation/Registration, if available
Accepted file types: pdf, doc, docx, txt, Max. file size: 20 MB.
Boat photo, if available
Accepted file types: jpg, gif, png, tif, Max. file size: 10 MB.
Sailing Experience
Please provide a brief statement of the number of years you have been boating and a description of your sailing experience, including prior vessels owned.
- I would like to upload my sailing resume
- I would like to type this online
Sailing Resume
Max. file size: 128 MB.
Brief statement of the number of years you have been boating and a description of your sailing experience, including prior vessels owned.
Please feel free to share any life experiences, talents, or interests which you believe may be of interest to, or helpful to, the Club

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Sailors and Aspiring Sailors!

Name	Age

Name	Address	Telephone	Email