Columbia Yacht Club 2020 Membership Application

1Name/address/employer > 2Dependents > 3Emergency Contacts > 4Yacht Enrollment > 5Correspondence Preference > 6Membership Questions > 7Signatures > 8Review Your Entry
Applying for which membership status *

Applying for which membership status Regular Member Associate Member Reinstatement Regular Reinstatement Associate

If you own a boat moored within 35 miles of the Club Ship, you must apply for Regular membership. If you do not own a boat moored within 35 miles of the Club Ship, you may apply for Regular or Associate membership.
Name Name * First Last
Gender *

Gender Male Female
Primary Home Address Primary Home Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Primary contact phone number Primary contact phone number * - ### - ### ####
Primary phone number type *

Primary phone number type Mobile Home Work
Secondary contact phone number Secondary contact phone number - ### - ### ####
Secondary phone number type

Secondary phone number type Mobile Home Work
Email *
Profession *
Name of Business/Employer *
Business Address Business Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Business Phone Business Phone * - ### - ### ####
Business Email *
Date of Birth Date of Birth * / MM / DD YYYY
Marital Status *

Marital Status Married Single

Spouses, domestic partners, and dependents under the age of 21 all share the same privileges of membership as the primary applicant.
Spouse Name (if applicable) Spouse Name (if applicable) Title First Last Suffix
Spouse Date of Birth Spouse Date of Birth / MM / DD YYYY
Spouse Email
Spouse Cell Phone Spouse Cell Phone - ### - ### ####
Do you have dependents under the age of 21? *

Do you have dependents under the age of 21? Yes No