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Buccaneer18 Class Association Membership Application

NAME_______________________________________________________


STREET ADDRESS_____________________________________________


CITY________________________STATE____________ZIP___________


HOME PHONE( _____ ) _____________________


WORK PHONE ( ____ ) _____________________
EMAIL ______________________________________________ 


HULL #_____________________BOAT NAME________________________
SAIL #___________

NUMBER OF YEARS YOU'VE OWNED YOUR BOAT __________
I AM A:
	SKIPPER/OWNER (  )  
	CREW/OWNER (  )  
	CREW (  )
	INTERESTED OBSERVER (  )

LOCAL CLUB AFFILIATION:
Club Name __________________________________________
Club Location ______________________________________
Number of Buccaneers in your fleet _________________
Do you actively race your Buccaneer? YES(  )  NO(  )

TYPE OF MEMBERSHIP		
(CHECK ONE)	Regular	(      )  
			Associate	(      ) Crew or does not own a Buccaneer

														
THIS MEMBERSHIP IS		
(CHECK ONE)	New		(     )
			Renewal	(     )


ANNUAL DUES (You may pay for a maximum of two years):        $35         
ANNUAL FEE FOR RECEIVING PRINTED BUCC NEWSLETTER : $5

	YEARS FOR WHICH YOU ARE PAYING:   20____  and   20____


	TOTAL AMOUNT ENCLOSED: $_________________


	MAKE CHECKS PAYABLE TO: THE BUCCANEER CLASS ASSOCIATION
PAYMENT OF DUES ENTITLES A MEMBER TO:

ADDRESS TO SEND APPLICATION:

Buccaneer National Class Association
Attention Stuart Richman
8209 Seven Pines Lane
Waldorf, MD 20603

email: signmeup@buccaneer18.org