HARRODS CREEK BOAT OWNERS ASSOCIATION
P.O. Box 316, Harrods Creek KY  40027
MEMBERSHIP APPLICATION         
Date
Name:_____________________________________________________________________________________

Address:___________________________________________________________________________________

City:_____________________________________ State:________ Zip:_________________________________

Home Phone:(_____)____________E-Mail Adress:_________________________________________________

Place of Employment:________________________________ Phone(_____)_____________________________

Address:______________________________ City_______________ State____ Zip_______________________

Do you own a Boat?______   Boat Name:_________________________________________________________

Make___________________      Model___________________________________________________________

Have you completed courses in boating safety?____________________________________________________

If yes, please list_____________________________________________________________________________

Applicant must be sponsored by at least two (2) active members.

Signature______________________________ Signature_________________________________

Signature of Applicant_____________________________________________________________

1st Year fee $50.  Annual Membership $40.  Please remit $90.00 to the above address.
Annual Membership Dues & Initiation Fee are Per Person
Member Must Be At Least 21 Years of Age.
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Name
Address
City
State
Zip
Home Phone Number
E-Mail Address
Employer
Employer Phone #.
Employer Address.
Employer City State Zip.
Do You Own a Boat?
Name of Boat
Make of Boat
Model of Boat
Have You Completed Courses in Boating Safety?
If yes, please list
Applicant must be sponsored by at least two (2) active members.
Signature of Active Member
Signature of Active Member
Signature of Applicant                  I am at least 21 years of age.
1st Year Fee $50.  Annual Membership $40.  Please remit $90 to to above address.
Annual Membership Dues & Initiation Fee are Per Person.
Member Must Be At Least 21 Years of Age.
HARRODS CREEK BOAT OWNERS ASSOCIATION
P.O. Box 316, Harrods Creek KY  40027
MEMBERSHIP APPLICATION         
Date:______________________________________________
This page was last updated by Diana Clouse on: February 22, 2009
Please complete one of the forms below and send with your check  to our P.O. Box.
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No
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No