2010 LMCA

Name:__________________________________email: _____________________________

First Mate:______________________________email: _____________________________

Street: ___________________________________________________________________

City: ________________________________________State:_______Zip: _____________

Phone:(home)____________________________(cell/W) ___________________________

Boat Name: __________________________________________________ LOA:_________

Boat Regist.#: ____________________________ Sail#: ____________ Model:_________

If not a Catalina, please describe: _____________________________________________

Home Port/marina: __________________________________________________________

Children's Names and Ages:___________________________________________________

To aid the Board of Directors in programming, please circle all interests that apply:
Racing, Cruising, Social Activities, Educational Seminars, Other (specify)______________

I would prefer to receive the newsletter (check one or both) [ ] by mail and/or [ ] email.

PAYMENT: Check all that apply:
[ ] Initiation Fee $10.00 (1st year only)
[ ] Annual Dues $25.00
[ ] Mainsheet Subscription $12.00 (optional)

$                   Total Enclosed - (make check payable to: Lake Michigan Catalina Assn)

Mail completed application and check to:
LMCA - c/o Kay Sapita
825 Center Street
P.O. Box 581
Douglas, MI 40406