New Buffalo Yacht Club

​​Membership Application

Please print and complete. 


Date:_____________


Name: _________________________________________

 Spouse’s Name: _________________________________ (H) Phone: ___________________________

 Address: _______________________________________ (O) Phone: ___________________________
 
 City: __________________________________________ State ___________________ Zip: _________ 

Primary Email: __________________________________ 2nd Email: ______________________________ 

Employer: ______________________________ Job Description: __________________________

Boat Name: __________________________ Power ___ Sail___ Moored At: _____________________

Sponsor’s Printed Name  / Sponsor's Signature
__________________________________ / ________________________________________

__________________________________ / ________________________________________

__________________________________ / ________________________________________


​​Club Use Only

Interviewed by: ________________________________________________
________________________________________________
________________________________________________

Approved by BOD: _______yes__________no

Date____________________

Dues Paid:__________ Initiation Fee:________



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