Print out and mail to Class Secretary below

New _____ Transfer______ Class of Boat Columbia 42
Manufacturer's Hull Number _____________
Manufacturer's Name ______________________ Or If Home Built Please Check Here _____
Club Affiliation Name ______________________________________
AMYA Membership # ________________
If this is a transfer: Purchased from: _____________________________________________
Sail # ___________
My name is: ___________________________________
Address: ______________________________________
City __________________________________________ State_______ Zip Code: __________
Telephone ( __ __ __ ) __ __ __ - __ __ __ __
E-Mail ____________________________________________
Each Registration or transfer is $10.00 U.S.
Make Payable to the Class Secretary.

Class Secretary
Name: Thomas  (Tom)  Walker
Address: 27 Kenosia Ave
City/St/Zip: Danbury, CT 06877
Phone: 914 420-1444