Please provide the following contact information:

Name
E-Mail
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work/Cell Phone
Home Phone
Hull #
Boat Name
Sail #
I am a	Skipper/Owner Crew/Owner Crew Interested Observer
Sailing Club name
Sailing Club Location
Local Fleet Affiliation	0 None 30 Rocky Mountain 49 California 54 North Shore Yacht Club (IL) 59 Carolinas 69 Southern Maryland 76 Mid Atlantic 79 Arizona 80 Nor'easters 90 Creve Coeur (MO) 91 Alabama 100 Canada
# of Buccaneers you own	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
This Membership is	New Renewal
Years you wish to join	1 ($35) 2 ($70)
Receive "The Bucc" Newsletter By Mail? (Annual fee for printed copy of the "Bucc")	Yes, one year ($5) Yes, two years ($10) No