International Mirror Class Association of Tasmania

RENEWAL/APPLICATION FOR MEMBERSHIP 2009/2010

NAME: ......................................................................................................................................................

ADDRESS: ................................................................................................................................................

POSTCODE: .............................................................................................................................................

PHONE: .(.....)........................................... EMAIL: ..................................................................................

NAME OF BOAT:.....................................................................................................................................

SAIL NUMBER: .......................................................................................................................................

YEAR PURCHASED OR BUILT: ............................................................................................................

PREVIOUS OWNER (IF APPLICABLE): ...............................................................................................

REGISTRATION CERTIFICATE ISSUED: YES / NO

All sailing members of IMCAT are required to be a member of Yachting Australia through an
affiliated club.

I AM A MEMBER OF THE FOLLOWING SAILING CLUB/S:

......................................................................................................................................................................

SUBSCRIPTION RATES:

Membership and Boat Registration: $30.00

Membership Only (No Boat): $5.00

Mirror Booklet: $10.00

REMITTANCE ENCLOSED: $........................

I hereby apply for membership of the IMCAT for 2009/2010 and agree to abide by the rules of the Association

SIGNED: ................................................................DATE: ..................

Forward subscriptions to:

John Behrens
Honorary Treasurer
53 Loatta Road
LINDISFARNE, TASMANIA. 7015