PEN APPLICATION FORM

APPLICATION TYPE

Application Type:

Pen
Transfer to another Pen of the same size
Request a Larger or Smaller Pen

MEMBER DETAILS

Member Name *

Membership Number

Membership Class (Full or Life) *

Email Address *

Mobile Number *

OTHER OWNER IF APPLICABLE (These people must be Full or Life Members)

Member Name

Membership Number

Membership Class (Full or Life)

Email Address

Mobile Number

WATERCRAFT DETAILS

Name

Dot Registration No

Make/Model

Type *

Power
Yacht

Hull Type *

Mono Hull
Multi Hull

Sail Number

Overall Length (LOA) *

Beam

Draft

Where is your watercraft now?

Do you need a temporary pen before a permanent is available?

NB: If you do not yet have a watercraft to occupy the pen, please write "Vessel to be purchased" over this area.

DECLARATION BY MEMBER/S

I acknowledge that the above particulars are true in every respect and understand that if any of these particulars change, I will notify the Club immediately.

I also acknowledge that acceptance of this application form does not constitute an offer for a pen, but rather entitles the applicant to be placed on a waiting list for consideration when a suitable vacancy becomes available.

I understand both the applicant/s and the watercraft must meet the Club's Pen Regulations for the use of the facilities.

A non-refundable management fee of $220 is payable on lodgement of this form.

Logement Fee

Price: $220.00

Total

$0.00

Stripe Credit Card *

Card

Name on Card