QUEENSCLIFF CRUISING YACHT CLUB

Membership Application Form

Please complete this form online and click 'Submit'. There is no need to print the form.

Please also note the requirement for your application to be supported by two current members of Queenscliff Cruising Yacht Club (and who are not part of the same family membership) who should each complete a Proposer Form available via the Club website (qcyc.org.au)

If you wish to apply to place your boat on the QCYC Boat Register, you will also need to complete an online Boat Register Application Form, available via the club website (qcyc.org.au).

Personal Details

Name*

First NameLast Name

Date of birth*

Date

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Mobile*

Please enter a valid phone number.Format: 0000 000 000.

YesNo

When were you a member?

Other YC(s) to which you belong*

If none, type None

Occupation*

YesNoUnsure

If uncertain, please confirm your Australian Sailing number by visiting

https://www.sailing.org.au/member-finder/

What is your Australian Sailing number?*

YesNo

Membership Category

SeniorIntermediateFamily

Partner's full name*

First NameLast Name

Partner's email address*

example@example.com

Partner's phone number*

Please enter a valid phone number.Format: 0000 000 000.

Partner's date of birth*

Date

Enter name and date of birth of each child under 18 years that will be included in a family membership

eg John Smith, 01/01/2003

Intentions

A base for Bay/Ocean cruisingA base for Ocean racingA base for weekend or holiday social activitiesTo enjoy social sailing

YesNo

Where is your permanent berth or mooring?*

YesNo

Please explain in a sentence or two why you are interested in joining QCYC*

Proposers

We ask that your application is supported by two current members of Queenscliff Cruising Yacht Club (not part of the same family membership) and that you enter their names below. Each member should then complete a Proposer Form, available via the Club website (qcyc.org.au)

However if you do not know anyone from the Club, please enter 'TBA' in the fields below and contact the Hon Secretary (secretary@qcyc.org.au) who will be able to advise.

Name of First Proposer*

Please ask this person to complete an online proposer form

Name of Second Proposer*

Please ask this person to complete an online proposer form

Declaration

I hereby apply for membership of Queenscliff Cruising Yacht Club and undertake, if elected, to observe and be governed by the Club Rules and By-Laws. I declare that the information supplied above is correct.