Boat Slip Application

Slip Application For Marina Cortez San Diego

NOTE: Review ALL fields of information needed and gather all your facts BEFORE starting to submit this form. For best results, copy/paste your prepared answers into the form.
Use the expanding sections below to enter & submit your information.
- Date Slip Is Needed*
  
  MonthDayYear
  Date
- Former/Present Birthing*
  Who is (or was) your previous slip provider
- How did you hear about us?
- (1) Applicant - Name Of Primary Vessel Owner*
  
  First NameMiddle NameLast Name
- Own or Rent Home*
  Use drop-down, select one
- Home (Mailing) Address*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Home Phone Number*
  
  Area CodePhone Number
- Cell-Phone Number*
  
  Area CodePhone Number
- Work Phone Number*
  
  Area CodePhone Number
- Personal Email*
  example@example.com
- Work Email
  example@example.com
- Employed By*
  List you employer OR TAX ID number if self-employed
- How Long Employed*
  Or, how long self-employed
- (2) Name Of (secondary/spouse/partner) Vessel Owner
  
  First NameMiddle NameLast Name
- Own or Rent Home
  Use dropdown, select one
- Home (Mailing) Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Home Phone Number
  
  Area CodePhone Number
- Cell-Phone Number
  
  Area CodePhone Number
- Work Phone Number
  
  Area CodePhone Number
- Personal Email
  example@example.com
- Work Email
  example@example.com
- Employed By
  List you employer OR TAX ID number if self-employed
- How Long Employed
  Or, how long self-employed
- Name Of Vessel*
- CF/Doc#*
- Legal Owner / Lien Holder of Boat*
  If YOU hold the legal title free and clear, enter = Aplicant
- Owner / Lien Holder Address
  Type the Street Address of Owner / Lien Holder
- City, State and Zip
  Type the City State and Zip
- Is this a charter vessel and/or have plans to use commercially?*
- Description Of Boat*
  
  PowerSailCruiserHouseholdCat/TrimaranInboardOutboardKit/Home BuiltGasDieselSingleTwinOther
- Date of Last Survey*
- Make / Model*
- Length*
  Length Overall - Pulpit to Swimstep/Outboard
- Beam*
- Year*
  Year Made
- Hull Material*
- Hull Color(s)*
  Boat's hull color(s)
- Upper Color(s)
  Top / Upper Color(s)
- Insurer's Name & Phone*
  ex: (Alpha Insurance - 222-222-2222)
- Insurance Agent Name & Phone*
  ex: (Tom Smith - 333-333-3333)
- Listed Names On Insurance Policy*
  Include all listed beneficiaries on policy. ex: (Bill Jones, Sally Jones, etc.)
- Type Of Coverage*
  ex: Protection & Indemnity
- Coverage Amount $*
  Dollar amount of total coverage
- Hull $
- Upload Picture(s) Of Your Boat
  
  Browse Files
  Upload a current digital photo of your boat Cancelof
- In case of boat sinking or another emergency when you are not available, Please list additional contacts.
- Emergency Contact #1*
  Name of emergency contact
- Contact # 1 Phone*
  
  Area CodePhone Number
- Emergency Contact #2
  Name of emergency contact
- Contact # 2 Phone
  
  Area CodePhone Number
- Emergency Contact #3
  Name of emergency contact
- Contact # 3 Phone
  
  Area CodePhone Number
- Emergency Contact #4
  Name of emergency contact
- Contact # 4 Phone
  
  Area CodePhone Number
- Are you interested in the following?
  
  Live AboardCharteringAir BnBCommercial Activity
- Would you like to receive our monthly newsletter?
  
  Yes, I'll opt-in to the newsletter.No, thank you!
- It is hereby understood that all Applicant(s) named above, except invited guests, are the only persons authorized to use the boat designated above. The applicant represents that statements above are true and correct and hereby authorizes the release of information for verification of statements made by Applicant(s). This is an application for the right to use Marina property. Any other use of Marina property requires a signed agreement by Marina.
  
  READ CAREFULLY: BY CLICKING THE SEND INFO BUTTON BELOW THEREBY SENDING THE COMPLETED APPLICATION TO US,
  - You are acknowledging that: The information on this application is true and correct to the best of your knowledge. AND:
  - You (the Applicant(s) as named above) hereby authorizes the Marina to process this online application submission on your behalf.
- Click button to agree...*
  
  Yes, I agree.
- Should be Empty:

Slip Application For Marina Cortez San Diego