PEQUONNOCK YACHT CLUB AUXILIARY APPLICATION
DATE: _____________________________________________________________
NAME: ____________________________________________________________
ADDRESS: __________________________________________________________
CITY, STATE, ZIP: _____________________________________________________
HOME PHONE: ______________________________________________________
CELL PHONE: ________________________________________________________
EMAIL ADDRESS: ____________________________________________________
BIRTH DATE, YEAR NOT REQ’D, MUST BE OVER 18: _________________________
SPONSOR MEMBER’S NAME: __________________________________________
MEMBER’S ELECTION DATE: ___________________________________________
RELATIONSHIP TO MEMBER: ___________________________________________
MEMBER’S SIGNATURE: ______________________________________
DUES PAID - $25: ____________________________________________________
Please print and submit at club or office or save as PDF and email to address below.
Contact: [email protected]
DATE: _____________________________________________________________
NAME: ____________________________________________________________
ADDRESS: __________________________________________________________
CITY, STATE, ZIP: _____________________________________________________
HOME PHONE: ______________________________________________________
CELL PHONE: ________________________________________________________
EMAIL ADDRESS: ____________________________________________________
BIRTH DATE, YEAR NOT REQ’D, MUST BE OVER 18: _________________________
SPONSOR MEMBER’S NAME: __________________________________________
MEMBER’S ELECTION DATE: ___________________________________________
RELATIONSHIP TO MEMBER: ___________________________________________
MEMBER’S SIGNATURE: ______________________________________
DUES PAID - $25: ____________________________________________________
Please print and submit at club or office or save as PDF and email to address below.
Contact: [email protected]