|
Use the print command from your browser to print this form |
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:
Buccaneer National Class Association Attention Stuart Richman 8209 Seven Pines Lane Waldorf, MD 20603 email: signmeup@buccaneer18.org