Your Name, Spouse’s Name

Mailing Address

City/State/Zip

Phone (Home)

Phone (Cell, Work, Other)

Email Address*

Manufacturer, Model:

Length:

Year:

Sail Number:

Boat Name:

Keel:

Centerboard       Daggerboard       Deep Keel       Fin Keel       Swing Keel       Wing Keel

Mast:

Short Mast     Tall Mast     Very Tall Mast                  Indicate:     Masthead Rig      Fractional Rig

Sails:

Spinnaker       110 Jib       150 Jib       Roller Furling       Other:

Engine:

Inboard     Outboard

Backstay:

Adjustable      Non-adjustable

Other: