Membership Application
(Mail Version)

To submit your application, Print out this page on your printer and send it and a check for the membership fee (US $35) payable to Joshua Slocum Society International Inc. to:

Joshua Slocum Society International Inc.
15 Codfish Hill Rd. Ext.
Bethel, CT 06801, USA

Please Note:
If you are out of the U.S.A. funds are acceptable in U.S. cash or International Money Order only.

Application for Membership

First Name ___________________________      Last Name ___________________________

Address ______________________________________________________________________

City ___________________________      State/Province ____________________  

Zip/Postal Code _________________      Country ________________________

Telephone ___________________  

Fax ______________________   

E-mail ____________________________

Boat Name  __________________________________
Boat ownership is not a membership requirement)

Size/Type/Rig ____________________________________________

Hailing Port ___________________________________

Radio Call ____________________________________

Please enclose a note about your ocean passages/sailing/cruising
experience and/or comments, area of interest

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

Signed ____________________________________  Date __________________

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