New England Beetle Cat Boat Association

New Membership Application Form

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Name________________________________________

Street______________________________________

City, State, ZIP________________________________________

Phone_______________________________________

Second address (summer address):

Street______________________________________

City, State, ZIP_________________________________________

Phone_______________________________________

Email_______________________________________

Family members:__________________________________________________________________

Beetle Cat Owners please provide information on your boat:

Boat Name_________________________________

Hull number_________________________

Sailnumber__________________________

Home port___________________________

Year first launched (if known)_____________

Yacht Club affiliation (if any)____________________________________

Please check one:

( ) Individual membership $10
( ) Family Membership $15
( ) Contributing Membership $25

Please make check payable to NEBCBA and mail along with this form to:

			Sueanne Bouchie, Treasurer
			PO Box 1102
			North Falmouth, MA 02556