Eglin Yacht Club Membership Application

This form should be filled out then printed and given to the Eglin Yacht Club Membership Chairman

Member Information
First Name / Last Name
Spouse’s Name / Do you have internet access? / Yes / No
Address:
City: / State: / Zip:
Home Phone: / Work Phone: / Rank/Grade:
Email Address:
Your Status:
Military / Civil Service / Contractor--and you are / Active / Retired / Widowed
Boating Information
Boat Name / Type / Size
Make Model / Registration Number
Dive Information
Date of Certification: / Type of Certification:
Certifying Organization: / Registration on NR:
Date of Last Physical: / Instructor NR:
Authentication By: / Date of Authentication:
Activities of Interest
Please mark the social activities you are interested in and you will receive information on specific events.
Canoe/Kayak/Paddleboard / Fishing (Day Trip – Bay/Gulf) / Fishing (Overnight Trip)
Boat trips (Day) (jet ski, small boat) / Excursions (Sleep on Boat) / Overnight Boat Trips (lodging expected)
Crew / Sailing / Extra Hands (help and learn boat repair)
EYC Socials (game night) / EYC Ambassador at Functions / Booster Club Fund Raising Events
Spear fishing / Dive Day Trips / Dive Overnight Trip
Please list any other activity that you are interested in but is not listed above:

Please Note
The Eglin Yacht Club is a social organization run by volunteer member's manpower. When you join, you and your spouse will be expected to volunteer your time for one of the duties listed below. Please check each of the following that you would desire to serve:

Bartender / Hamburger Night cooking crew chief / Hamburger night crew helper
Dive equipment rental duty / Membership dinner crew chief / Membership dinner crew helper
Club self-help projects / Wash dishes/meal cleaning / Other tasks as needed

Please list any self-help expertise you have, i.e., plumbing, carpentry, painting, electrical, design/layout, etc.

Date ofApplication: / Signature:

Membership Application Form - 2016