EMSWORTH CRUISING ASSOCIATION
SUBSCRIPTION RENEWAL - DUE : 1st JANUARY 2010
Please complete
your name plus any item that has changed
from last year's Yearbook entry
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Name: |
Boat Name: |
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Address: |
Boat Type: |
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Sail No: |
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Mooring: |
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Postcode: |
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Telephone No.: |
Retired: YES/NO |
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e-mail address: |
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MMSI Number: |
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I HAVE THIRD PARTY INSURANCE ON MY BOAT. Tick box to confirm. |
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Subscription: Non-Boat Members - £17.50 Boat Owners £30.00 |
£ |
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An additional Yearbook £1.00 |
£ |
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Club Burgee (18" at £16.00 or 24" at £18.00) |
£ |
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Club Tie £9.00 |
£ |
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Total |
£ |
Cheque payable to Emsworth Cruising Association.
NB. Please pay promptly. If not paid by 28th February,
your entry in the Yearbook will be deleted.
Please return your subscription as soon as possible to:
The Membership Secretary,
Mr J. R. Burton, Manor Barn, Prinsted Lane, Prinsted, Emsworth, Hants, PO10 8HR.
This form is only for current members and should be returned by 28th Feb latest.
To print this: right-click the form, select 'Print' and accept 'Only the selected frame.'
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