FBYC Membership

Questionnaire

Name: ________________________

Address: ______________________

City: _________________________
State: ________________________

Zip: _________________________

Phone Number: ________________

Email Address: _________________

Boat Type (Sail/Power/Length): _________

Boat Name: ________________________

Print this page, fill it out by hand and mail it, along with a check for $15 to:

Mrs. Joyce Clautice

8914 Mangum Place

Alexandria, VA 22308