Pasquotank River Yacht Club

P.O. BOX 612

ELIZABETH CITY, NORTH CAROLINA 27907-0612

MAIL APPLICATION FOR MEMBERSHIP TO: FRANK SHIPLEY, TREASURER P.O. BOX 612 ELIZABETH CITY, NC 27907-0612		FEE $ 50.00/YR DATE REC.___________ CK.______CASH______ AMOUNT____________ CARD ISSUED________
RENEWAL__________	NEW__________
NAME:_________________________________	SPOUSE:_____________________________

ADDRESS:___________________________________________________________________

___________________________________________________________________

PHONE: (HOME) ______-______-______ (WORK) ______-______-______

EMAIL ADDRESS:__________________________________________________

NEW MEMBER SPONSORS:

Ø ____________________________________________________

Ø ____________________________________________________

PERSONAL INTEREST............. (activities in which you would like to assist or participate)

SOCIALS______	CRUISES______	RACING______
REGATTAS______	CREWING______	MARINA______

VESSEL INFORMATION

POWER__________	SAIL__________
MAKE____________________________________________________	LENGTH______
NAME____________________________________________________

Suggestions/Comments that you wish the trustees to be aware of and/or act upon.