Alexandra Yacht Club Application for Membership

Personal Details (Please use block letters) Surname Forename Title Address Telephone Home Mobile

Postcode E-Mail Date of Birth Profession/Occupation RYA Qualifications

Family Details Partner Surname Forename Date of Birth Child Name Date of Birth Child Name Date of Birth Child Name Date of Birth

Emergency Contact (In case of emergency please notify) Name Relationship Telephone Address

Categories of Membership (Please place a tick mark alongside the category for which you are applying) Category Rights Annual Joining Tick Fee Fee Box Full Family Membership** Voting & Sailing £110 £40 Applicable to 2 nominated adults living at the same address Full Individual Membership Voting & Sailing £100 £40 Applicable to 1 adult (over age 18) Family Cadet Membership No Voting. Can Sail £0 £0 Up to age 17 whose parent(s) are Full Members Individual Cadet Membership No Voting. Can Sail £21 £0 Individual membership up to age 17 Midshipman Individual Membership No Voting. Can Sail £42 £0 Individual membership from age 18 to 21

Boat Details Boat 1 Boat 2 Boat 3 Name of Boat Class Length Over All Sail Number Jetty Space Required Yes or No Yes or No Yes or No Jetty Fees (Annual Fee)

Size of Boat Annual Jetty Number of Fees Due Fee Boats Boats of length 16 feet or less £75 (E.g. Topper, Laser, GP14, Wayfarer) Boats Greater than 16 feet in length £80

Membership Notes

Membership runs from 1 January to 31 December each year. Membership is due on 1 January.

If joining after 1 July then Full Membership annual fees are halved for that year only.

Under the rules of the Alexandra Yacht Club membership if granted, is subject to a one year probationary period.

Jetty Fees are separate from Membership Fees

** Includes family members who are in full-time education up to the age of 23. Proof of family members in full time education may be required. Please enclose full payment with your applications form to:

Postal Electronic The Treasurer Email: [email protected] 6 Capel Terrace, Sort: 08 92 99 Southend-on-Sea, Essex, Account: 65366815 SS1 1EX Name: Alexandra Yacht Club Limited Cheques payable to Alexandra Yacht Club Limited Reference: Your Name

I, the undersigned so agree that, if elected, by interview or vote, to Membership of the Alexandra Yacht Club, I hereby undertake to conform to the Rules and Regulations as now existing or as they may be hereafter legally altered, amended or enlarged. I accept that my details will be stored on computer for the purposes of the Club only and will not be made know elsewhere, except with my express consent.

Signature (s) of Candidate (s) ______Date ______

Proposer (Full Member)

Signature ______Print Name______

Membership Number ______

Seconder

Signature______Print Name______

Membership Number ______