Name (& Mate) _______________________________________________________________________

Home Address _________________________________________________________________________

City _______________________________________________________  State _______  Zip __________

Phone w/Area Code _______________________________    E-Mail address _________________________

Do you wish to be added to the SBBC-L Listserve?   ___ Yes    ___ No

Local Address____________________________________________  City _________________________
(if applicable)

Local Phone ________________________________     Send Mail  ___  No  ___ Yes   Dates: ____________

Boat Name __________________________________________ Make/Model/Size ___________________

   ___  Sail           ___  Power            Slip No. _______________  Slip/Mooring Location __________________

Interests:        ___  U.S.C.G. Aux. free inspection              ___  Sailboat Racing                 ___  Club Rendezvous

___ Future Boat Club Officer   ___  Help Plan/Organize Activities    ___ Other ______________
 
 

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