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2021 membership application
Personal Information
First Name
Last Name
Birthday
Email
Phone
Address
Profession or Occupation
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The Last Year I was a Member
Boat Ownership
Boat Owner
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Boat Type
Power
Sail
Manufacturer
Model
Boat Name
Marina
Dock
Sole Owner
Yes
No
If No, are the other owners currently members of Liberty Yacht Club?
Yes
No
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