.....VIRGINIA CHARTER BOAT ASSOCIATION

...............MEMBERSHIP APPLICATION


Directions: Complete the application with the necessary information.

Mail your dues check ($60 or $35, see below) to:

Rick Lockhart, Treasurer
490 Hardings Wharf Drive
Kilmarnock, VA 22482

Membership renewals can also be submitted by completing the
application below and paying annual dues.

 

Please fill in all information below. Captains also nned to complete
the Captain's license information for NACO membership and the
VCBA web site information for their web listing.

 

TYPE OF MEMBERSHIP  


Captain members must have a valid USCG Captain License - $60 annually
Associate members (persons with no USCG Captain License) - $35 annually

PERSONAL INFORMATION  

Last Name    First Name  

Address  

City, State, Zip  

Home #        Cell #  

Email Address (VCBA communications)  

USCG License # Expiration Date

 

WEB SITE INFORMATION (Captains only)                

Boat Name

 

Boat Location:

Northern Neck Middle Peninsula Peninsula

Tidewater Eastern Shore  

Telephone #1 Telephone #2  

Email Address Web Site  

Number of Passengers  

Recommended/Referred By:

Before sending, you may want to print this page for your records.