<p> Alexandra Yacht Club Application for Membership</p><p>Personal Details (Please use block letters) Surname Forename Title Address Telephone Home Mobile</p><p>Postcode E-Mail Date of Birth Profession/Occupation RYA Qualifications</p><p>Family Details Partner Surname Forename Date of Birth Child Name Date of Birth Child Name Date of Birth Child Name Date of Birth</p><p>Emergency Contact (In case of emergency please notify) Name Relationship Telephone Address</p><p>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</p><p>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)</p><p>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</p><p>Membership Notes</p><p>Membership runs from 1 January to 31 December each year. Membership is due on 1 January.</p><p>If joining after 1 July then Full Membership annual fees are halved for that year only.</p><p>Under the rules of the Alexandra Yacht Club membership if granted, is subject to a one year probationary period.</p><p>Jetty Fees are separate from Membership Fees</p><p>** 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:</p><p>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</p><p>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.</p><p>Signature (s) of Candidate (s) ______Date ______</p><p>Proposer (Full Member)</p><p>Signature ______Print Name______</p><p>Membership Number ______</p><p>Seconder</p><p>Signature______Print Name______</p><p>Membership Number ______</p>