ACBS & FLC MEMBERSHIP APPLICATION.......... please complete form and print copy...mailing address and phone # listed below

NAME (S)

ADDRESS CITY STATE/PROV.
COUNTRY POSTAL CODE

EVE.PHONE DAY PHONE

EMAIL ADDRESS

Dues (in US $) ACBS, FLC For individuals under age 21: Annual Junior (JM) $15 for ACBS, $5 for FLC. Junior Life (JL) $650. For individuals, and their spouses/partners : Annual Adult (AN) for ACBS $45 for FLC. $20. Adult Life (LM) $1000. For organizations (by business name): Annual Associate (AM) $200. Associate life (LA) $2000.

Type of ACBS Membership DUES

Type of FLC Membership DUES

TOTAL AMOUNT
For Junior Memberships, date of birth: (At age 21, Junior Memberships automatically become Adult Memberships.)
BOAT OWNED YEAR BUILDER

MODEL LOA HULL#

ENGINE MAKE CYL. HP

BOATS NAME (Please list additional boats on a separate sheet.)

contactushere@flc-acbs.org

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