Duck Island Yacht Club - Membership Application
 
DUCK ISLAND YACHT CLUB Inc.
PO BOX 593 * WESTBROOK, CONNECTICUT 06498
APPLICATION FOR MEMBERSHIP
TYPE OF MEMBERSHIP (check one)  ____Active  ____Conditional ____Social
 
Name_____________________________________________________________________
	Last			First		Spouse
Address__________________________________________________________________
     Street		   City			State	 Zip
Home Phone________________Fax________________E-mail_____________________
Children (names and ages)_______________________________________________
Occupation (Applicant)_______________________Company____________________
Work Address_____________________________________________________________
  	   Street		 City	        State Zip    Phone
Occupation (Spouse)__________________________Company_____________________
Work Address_____________________________________________________________
  	   Street		 City	        State Zip    Phone
Boat Name_______________Make____________Type___________Sail #___________
Boat Location___________________________________________________________
Proposed By:____________________________________________________________
Seconded By:________________________Seconded By:________________________
Proposer and Seconds must recommend applicant for membership by letter to
Secretary, DIYC

Member Responsibility:  I understand the success of Duck Island Yacht Club requires 100% involvement of its members.  I agree to do my part as an active contributor to the work responsibilities of the club.

The applicant understands and agrees to all of the requirements of 
Active Membership and to comply with all DIYC rules and bylaws.
Applicant's Signature______________________________Date_______________
Please forward application with all required fees(see Membership Options)to:
Secretary, Duck Island Yacht Club, P.O. Box 593, Westbrook, CT 06498
 

Copyright 1999, DIYC  rev. 9/30/2007