EMSWORTH CRUISING ASSOCIATION

Goods Application Form

For urgency, use the 'SUBMIT' button below; otherwise, print this form and post with a cheque made payable to:- Emsworth Cruising Association
Applications should be sent to:- Derek Ellinor, 10 Burnham Wood, Fareham, Hants, PO16 7UD.

Name Boat name Telephone No
(Postal/e-mail) address

Prices
Spare Yearbook	@	£	1.00	£	0 1 2
18" Club Burgee	@	£	18.00	£	0 1 2
24" Club Burgee	@	£	24.00	£	0 1 2
1 Motif Club Tie	@	£	10.00	£	0 1 2 3
Sew_on Badge	@	£	3.50	£	0 1 2 3 4 5 6
Club Sw/Shirt	@	£	15.00	£	0 1 2 3 4
	TOTAL			£

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