ANCHOR BOAT CLUB
Post Office Box 351501
Palm Coast, FL 32135
MEMBERSHIP APPLICATION
Date:
NAME:
Last First: First:
Address:
Boat Name:
Length:ft.
Beam
ft.
Radio:
Yes:
No: Electric req'd :amps
Telephone:
Biirthday:(Month/Day only)
Cell Phone: Mr.:
Mrs.:
Anniv.:
E-mail:
DUES:
INITIATION FEE:(NEW MEMBERS ONLY): $25 per person. New members to
receive product package consisting of one large burgee or license plate
per family: one hat per member.
ANNUAL DUES:
Family Membership (Captain, Mate and Dependent Children)
$100.00 per year
Individual (Single 21 years +) No Dependents
$50.00 per year
Have you previously been a member of a Boat Club?
Yes No If Yes, name and location of Club:
Were you involved in Committe work or did you serve on
the Board of Directors? Yes:
or No: If yes, outline your experience:
Have you successfully completed the Coast Guard Auxiliary or comparable
safe boating class? Yes:
or No:
ANCHOR BOAT CLUB COMMITTEES: (Indicate which committes you would
consider serving on.)
Membership: By-Laws : Social:
Audit:
Publicity: Nominating:
Telephone:
Other:
CLUB PRODUTS: Burgee, Hats, Liense Plates, Jackets, Shirts
Please make checks payable to: Anchor Boat Club, Inc. Initiation
(New Members Only) $
Applicant's Signature: ______________________________ Annual
Dues:............................. $
Sponsored By: ___________________________________ Burgee
or
License Plate
Application Rec'd By: ___________________________________ Hat:
.
Date Received: ___________
Waiting List Number: _____ TOTAL TO BE PAID:
$
NEW MEMBERS ONLY
DO NOT SEND MONEY WITH THE APPLICATION
PAYMENT DUE UPON ACCEPTANCE INTO THE ANCHOR BOAT CLUB
