BUCCANEER18 CLASS ASSOCIATION MEMBERSHIP APPLICATION

First Name:

Last Name:

Street Address:

City: State: (2 letter code)

Zip:

Home Phone: Work Phone:

Email:

Hull Number: Sail Number: Boat Name:

Year You Purchased Your Boat?:

I AM A:(Check One)

Skipper/Owner:

Crew/Owner:

Crew:

Interested Observer:

Club Name: Club Location:

How many Buccaneers are in your Club?: Do you actively race your Buccaneer?:

MEMBERSHIP TYPE:

(CHECK ONE) Regular/Owner: Associate: (i.e. non-Buccaneer18 Owner)

Years for which you are paying:20and 20

Annual Dues Amount: (Two years max):$35/yr $35.00 $70.00

Annual Fee For Receiving Printed Bucc Newsletter: $5/yr $0.00 $5.00 $10.00

Total Amount Enclosed: $35.00 $40.00 $70.00 $80.00