All members will receive a free listing in our Website Member Directory. The member directory is sortable on business name, member's name and state/town.

If you have a Web site, your member directory listing will be linked to your Web site.

* Required fields
Name *
E-mail Address *
How would you like to receive your Newsletter? *	Email US Mail
Street
City *
State
Zip
Home Phone:
Business Phone/Extension
Cell Phone
Fax Number
Business Name *
Membership type	Full Member (must have a current captain's license on file) Associate Member
Domain Name If you have one (www.yourname.com)
Boat Type/Make: example, C-Hawk center console)
Boat Name
Length Over All
Beam
MarinaName/Home Port (Used to create a Map to your Boat)
Marina/Mooring/ Street Address(MOST IMPORTANT-needed for Map)
Boat Address/City(Needed for Map)
Boat Address/State(Needed for Map)
Boat Address/Zip(Needed for Map)
Category #1 *	Blank Excursions Fishing Charters Professional Education-Schools Diving Boat Instruction Taxidermists Charter & Rental Sailing Charters Whale Watching
Category #2	Blank Excursions Fishing Charters Professional Education-Schools Diving Boat Instruction Taxidermists Charter & Rental Sailing Charters Whale Watching
Category #3	Blank Excursions Fishing Charters Professional Education-Schools Diving Boat Instruction Taxidermists Charter & Rental Sailing Charters Whale Watching
VHF Working Channels (Seperate by commas)
Number of Persons you will take: Example 1-6
Date on your Mariners License
Number on your Mariners License
Prefered Emblem (Decal)	Inside window( good for boats) Outside window decal( good for tinted windows)
What subjects would you like discussed at the monthly meetings?
Suggest a Speaker for the monthly meetings.
Comments

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