Membership Application

"*" indicates required fields

Name*

Mailing Address*

Street Address City State / Province / Region ZIP / Postal Code Country

TO BE FILLED OUT BY APPLICANT

I, apply for*

Social

Bondholder Membership

in this Point Independence Yacht Club, Inc., and if elected agree to abide by the By-Laws and Rules of the Club. I further affirm that the following information is correct to the best of my knowledge and belief.

I understand that if approved I am responsible for annual dues or fees as set by the Board of Directors*

Yes

Date*

Applicant's Signature*

Home Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Telephone*

Cell

Fax

Email*

If Different

Summer Address

Street Address City State / Province / Region ZIP / Postal Code Country

Telephone

Cell

Fax

1. Occupation*

Business and Position

Business Address

Street Address City State / Province / Region ZIP / Postal Code Country

Telephone/Fax

2. Spouse's Name*

Name and Ages of Other Members of the Family*

3. Applicant's Date of Birth*

Social Security Number*

4. Interests and Hobbies*

5. I am or have been a member of the following clubs*

6. List any Club Member, other than your two Sponsors, with whom you are acquainted*

7. Boat Name*

Hailing Port*

Manufacturer*

Draft*

Length Overall*

Beam*

APPLICANT'S STATEMENT

8. Why do you want to become a member of Point Independence Yacht Club?*

9. What special Interests or skills do you have that may be of value in the maintenance and operation of the Club?*

10. Describe your boating experience?*

11. Having filed an application for membership with the Point Independence Yacht Club I consent to have a Cori Check.

RULES OF THE ADMISSIONS COMMITTEE

(Please read carefully before submitting application to ensure action on this application)

Each section of this application must be filled out completely.
A photo of the applicant must be included.
Sponsoring members, must be member, in good standing for at least one year.
Sponsors must arrange for the introduction of candidates to the Admissions Committee (if requested).
This application must be supported by letters of recommendation from both sponsors.
Supplemental letters from other members are helpful but not required.
A sponsor must submit the complete application to the Chairman of the Admissions Committee.
The sponsors are responsible for fulfilling all these requirements.

TO BE FILLED OUT BY SPONSOR #1

How many years have you been a Member of PIYC?*

How many years have you known the Applicant?*

What social contact have you had?*

What are your business relations?*

Do you or your spouse know the Applicant's spouse socially?*

If there are children, do you know them personally?*

Have you entertained the Applicant and his/her family?*

Are you willing to recommend the Applicant and his/her family without reservations?*

Sponsor must submit a supporting letter of recommendation with this application. This letter should articulate the reasons why you wish to sponsor the Applicant.

Date*

Sponsor's Signature*

Telephone Number*

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

TO BE FILLED OUT BY SPONSOR #2

How many years have you been a Member of PIYC?*

How many years have you known the Applicant?*

What social contact have you had?*

What are your business relations?*

Do you or your spouse know the Applicant's spouse socially?*

If there are children, do you know them personally?*

Have you entertained the Applicant and his/her family?*

Are you willing to recommend the Applicant and his/her family without reservations?*

Sponsor must submit a supporting letter of recommendation with this application. This letter should articulate the reasons why you wish to sponsor the Applicant.

Date*

Sponsor's Signature*

Telephone Number*

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

ADMISSIONS COMMITTEE - CHAIRMAN*

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508-295-3972
15-17 Independence Lane
Onset, MA 02558
( 41.739473 / 70.6493 )

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Membership Application

TO BE FILLED OUT BY APPLICANT

APPLICANT'S STATEMENT

RULES OF THE ADMISSIONS COMMITTEE

TO BE FILLED OUT BY SPONSOR #1

TO BE FILLED OUT BY SPONSOR #2

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