2017 J/105 Class Association Annual Membership Application

Note: Please use this form ONLY IF YOU DO NOT register with the National Class Association through your local fleet or if you do not pay through the website using a credit card. Dues for 2017 membership are $75 for the first owner/co-owner for every boat and then $40 for subsequent Co-Owners and for Associates. Your dues for 2017 are $75.00
One of the best ways to insure your investment in this wonderful boat is to support the Class. Your dues go toward supporting the web site, the class activities, and the J/105 News. Checks covering 2017 membership for Owners and Associates should be made out to "J/105 Class Association" and mailed to the address below.
         
2017 Dues: $75.00
         
Owner__________________________________ Spouse/Significant Other_____________________

Address________________________________ List S/SO On Website (Y/N)? _________________

City __________________________________ E-mail_______________________________________

State/Zip:_____________________________ Country_________

Telephone: Days________________________ Evenings_____________________Fax_____________


Boat Name__________________________________________________________Hull #____________

Homeport Location_______________________Homeport State_______________________________

Deep draft (Y/N)________________________Wheel (Y/N)__________________________________

Additional (Associate) Members registering (specify Co-Owner, Other Helmsman):


Name___________________________________ E-mail_______________________________________ 

Address________________________________ 

City __________________________________

State/Zip:_____________________________ Country_________

Telephone: Days________________________ Evenings_____________________

 
Name___________________________________ E-mail_______________________________________ 

Address________________________________ 

City __________________________________

State/Zip:_____________________________ Country_________

Telephone: Days________________________ Evenings_____________________

Mail to:                            

Chris Howell
J/105 Class Association
1604 Ventana Dr.
Ruskin, FL 33573