Yacht Requested:
Name:
Occupation:
Daytime Phone:
Evening Phone:
E-mail Address:
Are you a US Citizen?
• If 'No', are any
• If 'Yes', Name:
How many years have
Do you own or have
• If 'Yes', how many
Have you previously
• If 'Yes', please
Boat Type/Size:
Dates of Charter:
Area Cruised:
Charter Company:
Have you ever cruised
...
• If 'Yes', as
Have you ever crossed
List all sailing and
List any yacht club
Have you had any
• If 'Yes', explain:
What is your expected
In Case of emergency
Relationship:
Phone:
Please list two personal
Reference #1:
Address:
Reference #2:
Please list all members
1)
2)
3)
4)
5)
6)
7)
8)
NOTE: