Boat America Course Enrollment Form
Each student, even if a member of the same family, will need to complete an individual registration form
Date
*
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State
Zip Code
E-mail
*
Phone Number
*
-
Area Code
Phone Number
Date of Birth
*
Class Date
February 1, 2025
March 1, 2025
April 5, 2025
May 3, 2025
June 7, 2025
July 12, 2025
September 13, 2025
Class from 9am to 5:30pm.
Best time and method to contact you.
How did you hear about our course?
Comments or questions:
Course Fees:
Course fee is $35 for an individual registration. There is a family rate of $35 for the first family member, then $25 for each additional family member taking the same course on the same date. Payment Methods: If paying by check make check payable to "USCGAUX Flotilla 22." Please mail your check to USCG Auxiliary, 710 Independence Lane, Acworth, GA 30102. Cash payments may be taken on the day of class.
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