Mail-in Form

P.O. Box 191, Bayport, New York, 11705

ENROLLMENT FORM

Name:

_____________________________________

Address:

_____________________________________

Town, Zip Code:

_____________________________________

Home Phone:

_____________________________________

Business Phone:

_____________________________________

Boat, Port:

_____________________________________

Your Website:

_____________________________________

Email:

_____________________________________
This is our primary way of communicating with our members!

ENROLLMENT FEES

	TYPE	FEE
	Party Boats over 50 Passengers	$800
	Inspected Charter Boats & Open Boats under 50 Passengers	$500
	Un-inspected Charter Boats	$250
	$250 Sponsor	$250
	$125 Sponsor	$125
	$75 Sponsor	$75
	$30 Sponsor	$30
	Sponsor (other)	$____

INSTRUCTIONS

Make all checks payable to United Boatmen of New York, Inc.

Mail to: United Boatmen, P.O. Box 191, Bayport, New York, 11705