Pine Island Boat Club New Member Application Form
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A Boat Club for fun, safety, friendship all with a community spirit.
A lifetime membership fee of $65.00 includes a PIBC burgee, additional burgees are $35.00 each.
Date:________________________________________________________________________
Name:_______________________________________________________________________
Local Address:________________________________________________________________
____________________________________________________________________________
Local Phone:______________________________Cell:_______________________________
Email Address:________________________________________________________________
Please email us at PIBCcommodore@gmail.com so we have your correct email address.
Boat Make/Type/Size:_________________________________________________________
Boat Name:__________________________________________________________________
Specify: Full or Part Time Resident:____________________________________________
Where are you from?__________________________________________________________
Sponsors Name:________________________________________________________________
Comments:_____________________________________________________________________
Please email us at PIBCcommodore@gmail.com so we have your correct email address.
Visit our website at www.pibc.info for more information about the club and upcoming events. There is also an email button on the bottom right hand side of every page.