Name	____________________________________
Spouse	____________________________________
Last Name
Address1	____________________________________
Address2	____________________________________
City	____________________________________
State	_________
Zip Code	_________
Country	________________
Phone	____________________
	____________________
Choose Password	____________________ *Passwords are Case Sensitive*
E-mail	____________________________________
Work Status	Employed___  Self-Employed____  Retired____   Military___
Number of Years Boating	1-5___  6_10____ 11-15___ 16-20___  21-30___  30Plus___
Do You Own a Boat?	Yes__    No__
Do you Plan on Cruising	Yes__    No__
If So, Where?	Coastal___ Blue Water___ Sail___ / Power____
Live Aboard	Yes___ No___
Boat Name	________________________________
Builder	________________________________
Length	__________
What area do you currently sail?	___Northeast ___Caribbean ___Southeast ___Mediterranean ___Gulf Coast ___South Pacific ___Southwest ___Indian Ocean ___Northwest ___Other ___Great Lakes
What areas do you plan to cruise	___Northeast ___Caribbean ___Southeast ___Mediterranean ___Gulf Coast ___South Pacific ___Southwest ___Indian Ocean ___Northwest ___Other ___Great Lakes