Member Data SubmissionPlease use the form below to submit your information for billing and the directory by December 12, 2022. "*" indicates required fieldsYour Name* First Last Slip #*CDD #Boat InformationMake*Model*Year*Registration Number*Billing DetailsYour Email* Cell Phone*Alternate PhoneBilling Address* Street Address City State / Province / Region ZIP / Postal Code Directory Information Although you are not required to list your contact information in this directory, we highly recommend keeping your information up to date for other members to contact you should the desire or need arise. If for some reason you do not want your contact information listed on the directory it will only list your name and slip number with no contact information for access by other members. Please make note of any specific preferences in that regard.Would you like to be listed in the Member Directory?*SelectYesNoEmail*Would you like your email address listed on the member directory listing?SelectNoYes, please use the same email listed aboveYes, but I would like to list a different email addressEmail*Please provide us with the email address you would like listed. Phone*Would you like your phone number listed on the member directory listing?SelectNoYes, please use my cell phone number listed aboveYes, please use my alternate phone number listed aboveYes, but I would like to list a different phone numberPhone*Please provide us with the phone number you would like listed.Address*Would you like your address listed on the member directory listing?SelectNoYes, please use my address listed aboveYes, but I would like to list a different addressAddress*Please provide us with the address you would like listed. Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Consent* I agree to the terms & conditions.By checking the box above, I agree to have my contact information listed in the secure online Membership Directory.CommentsPhoneThis field is for validation purposes and should be left unchanged.
