SOUTHERN SHORE YACHT CLUB
CLUB HOUSE AND ANCHORAGE
JACKSON PARK, INNER HARBOR
6401 S. RICHARDS DRIVE
CHICAGO, IL 60649
773-752-9686
SOUTHERN SHORE YACHT CLUB, INC.
RENEWAL MEMBERS INFORMATION SHEET. ALL INFORMATION WILL BE USED TO COMPILE THE NEW MEMBERSHIP DIRECTORY. PLEASE COMPLETE, CORRECT OR DELETE THE FOLLOWING INFORMATION.
NAME: FIRST_______________________ MIDDLE IN.__ LAST____________________________
CREW MEMBER__________________________________
ADDRESS______________________________CITY_________________________ STATE______
ZIP(NINE DIGITS)________________
HOME#____________________CELL#_____________________ PAGER#__________________
OFFICE#___________________ BOAT#____________________
BOAT NAME____________________________ MAKE OF BOAT____________________________
LENGTH____________ SLIP/DOCK ASSIGNMENT________________________________
EMAIL ADDRESS______________________________________________
2009 DUES PAID BY MARCH 31ST $400.00
2009 DUES PAID BY MAY 31ST $450.00
2009 DUES PAID AFTER MAY 31ST $500.00
2009 ASSOCIATE MEMBER DUES $250.00
I AM ENCLOSING A CHECK FOR:
MEMBERSHIP FEE(PER SCHEDULE) $______
LOCKER($10) LOCKER # $______
ONE ADDITIONAL KEY CAR($10) $______
TOTAL ENCLOSED $______
MAIL PAYMENTS & RENEWAL FORMS TO:
TONY CROWE, TREASURER
3044 W. 47TH ST.
CHICAGO, IL 60632
