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Roster Questionnaire 2025
Submit this questionnaire only if you have revisions for the 2025 CYC Membership Roster by February 7, 2025
Roster Questionnaire
Name:
*
First & Last
Member Number:
*
Date of Birth:
*
Address:
*
City:
*
State:
*
ZIP code:
*
E-mail:
*
Phone Number:
*
(
)
-
First three digits
Second three digits
Last four digits
Business Phone Number:
(
)
-
First three digits
Second three digits
Last four digits
Boat Name:
Boat Model:
Spouse's Name:
First & Last
Spouse's Date of Birth:
Spouse's E-mail:
Spouse's Phone Number:
(
)
-
First three digits
Second three digits
Last four digits
Domestic Partner's Name:
First & Last
Domestic Partner's Date of Birth:
Domestic Partner's Email:
Domestic Partner's Phone Number:
(
)
-
First three digits
Second three digits
Last four digits
Child's Name Under Age 23:
First & Last
Child's Date of Birth:
Child's Name Under Age 23:
First & Last
Child's Date of Birth:
Child's Name Under Age 23:
First & Last
Child's Date of Birth:
Child's Name Under Age 23:
First & Last
Child's Date of Birth: