Membership Status Change Request
Your Name
*
Email
*
example@example.com
Requested Status Change
*
Please Select
Resignation
Senior (10+ years of membership & at least 65 years old)
Associate (Same reqm'ts as Senior but pays 50% dues & cannot store boats, vote, hold office)
Inactive (out of town for at least 1 year)
Honorary
Your Birthdate
*
-
Month
-
Day
Year
Note: Work Hours do not become optional until the calendar year AFTER Senior status is granted by the Board (see Handbook § H)
Do you have (or have you just sold) a boat/trailer stored at CYC?
*
Yes
No
Has the boat/trailer been moved from your slip/mooring/trailer parking spot?
*
Yes
No
How many completed work hours does your card show?
*
Please specify reason for leaving
*
Doed not have to be lengthy, 256 characters.
Signature
*
Submit
Should be Empty: