Membership Application
 

Please complete the form below and press send. Your application will be emailed to us for processing


Note: Fields marked with a "*" are required

Date*


Name* (Last, your first and spouse's first):


Street Address*


City, State, Zip*


Email


Home Phone*


Cell Phone


Boat Name


Boat Type


Manufacturer/Model


Length


Beam


Draft


Air Draft (Height Above Water)


Electrical Service Requirements
One 30 Amp
Two 30 Amp
One 50 Amp
One 50 Amp or two 30 Amp

Boat Storage Location


Slip # (if at GPYC)