BOAT OWNERS' ASSOCIATION OF NSW (INC)MEMBERSHIP APPLICATION

Please complete this form, print it, sign it, and mail it to

Secretary, BOA NSW
P.O. Box 212,  Spit Junction  NSW  2088
or fax it to (02) 9960 1859

 

 

Surname

First Name/Initial
 

Title (Mr/Ms/Mrs/Miss/Dr etc)

Occupation (Optional)

Street Address

Postal Address (if different)

Suburb / State / Postcode

Suburb / State / Postcode

Phone number

Mobile Number

Fax number

E-mail Address

New Subscription

Additional Contribution

First Year Membership $30*

Payment Method

Card Type

Credit Card    Cheque     Money Order

   Bankcard     Mastercard      Visa

Card Number

Expiry Date (month/year)

Total Amount Signature

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Vessel Details

Boat Name

Vessel Registration No. (Waterways)

Length

Type

  Trailer  Moored     Sail  Power

Location of mooring (eg, name of bay)

Mooring Number (if applicable)

Signed

Date

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