Membership Application   

Boat Name _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Type of Boat _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Where Boat is usually stored _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Members’ Names _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

                            _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Postal Address  _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Email Address_ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _

Telephone_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Mobile Phone _ _ _ _ _ _ _ _ _ _ _ _ _

Home Port _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Signature of Nominee  _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date _ _ _ _ _ _ _ _ _ _

Nominated by:    _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (Signature & Name)

Seconded by:  _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _(Signature & Name)

Email address for BCYC is info@bcyc.net.au
Web site is www.bcyc.net.au

Please include fees with application:            $12 per member or $20 per family. 

Please submit application to:
The Secretary
Bundaberg Cruising Yacht Club
PO Box 1567
Bundaberg. Qld 4670

Please print this form, complete it and post it together with your fees to
PO Box 1567, Bundaberg Qld 4670