Annapolis InterClub Fleet - Registration Form

Annapolis InterClub Fleet - Registration Form
Print, Complete and Mail Today!
(When printing make sure to set print setup to "Portrait")

Name: ________________________________________

(Please Print Legibly)

Address: ________________________________________

(street)

________________________________________

(city, state, zip)

Home Phone: ________________________________________

Work Phone: ________________________________________

e-mail address: ________________________________________

(note: there is an IC mailing list; you will be added unless you specify otherwise)

Boat Number: IC# _________

SSA Member?: yes    no

(circle one)

If yes, type: voting    associate    winter    other

(circle one)

Web Access?: yes    no

(circle one)

Choose one: Skipper    Crew

(circle one)

Registration Fee $40 (Skipper Only - Crews are encouraged to contribute $10)
Make checks payable to Annapolis InterClub Fleet

Mail to: Greg Leonard
13405 Valley View Road
Towson, MD 21286

(Or bring to SSA on Sunday with your IC!)


Name:	________________________________________
	(Please Print Legibly)

Address:	________________________________________
	(street)

	________________________________________
	(city, state, zip)

Home Phone:	________________________________________

Work Phone:	________________________________________

e-mail address:	________________________________________
	(note: there is an IC mailing list; you will be added unless you specify otherwise)

Boat Number:	IC# _________

SSA Member?:	yes no
	(circle one)

If yes, type:	voting associate winter other
	(circle one)

Web Access?:	yes no
	(circle one)

Choose one:	Skipper Crew
	(circle one)

Registration Fee $40 (Skipper Only - Crews are encouraged to contribute $10) Make checks payable to Annapolis InterClub Fleet

Mail to:	Greg Leonard 13405 Valley View Road Towson, MD 21286

	(Or bring to SSA on Sunday with your IC!)