VCYC Form

Vanuatu Cruising Yacht Club
VCYC Membership Form
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Name

Christian Name (s)Family Name (s)
Postal Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Type of Membership
*All dinghy usage as per VCYC Terms & Conditions
No of family members
Name of family members
e.g James Hill (7)
Payment Method
BANK: ANZ PORT VILA

ACCOUNT NUMBER : 803382

ACCOUNT NAME: VANUATU CRUISING YACHT CLUB

SWIFT: ANZBVUVX
Upload Payment Confirmation

Bank transfer/ cheque picture
Cancelof
Cash Payment only
Who recieved cash payment
Cash Payment Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
WELCOME ABOARD!!

MEMBERSHIP IS VALID ONE YEAR FROM DATE OF PAYMENT
OFFICE USE ONLY
Membership Number
RECEIPT
Payment received for Vanuatu Cruising Yacht Club Membership
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Type
From

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Paid

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Received with thanks.
On behalf of the Vanuatu Cruising Yacht Club
Should be Empty: