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:_________________________
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 _______________
Proposer and Seconds must recommend applicant for membership by completing
the New Recommendation Form. All completed forms are to be submitted to
the Proposer of this member. The proposer will then forward all completed
forms with appropriate fees (see Membership Options) to:
Secretary, Duck Island Yacht Club, P.O. Box 593, Westbrook, CT 06498
Copyright 1999, DIYC rev.
11/03/2009