ABBEY YATCH CLUB 2001 MEMBERSHIP FORM

Fill this out EXACTLY as you wish information to appear in the AYC Directory
Please Type or Print CLEARLY to assure accuracy


AYC Member:

Last Name ___________________________________  First ______________________________

Spouse / Significant Other:

Last Name ___________________________________  First ______________________________
 
Member Address _________________________________________________________________

City _______________________________ State ______________ Zip _____________-________

E-Mail Address ______________________________@__________________________________

Home Phone     (     ___ )  _______-___________    Local Phone ( __       )  _______-___________ 

Business Phone (        __)  _______-___________     Cell Phone  (      __  )  _______-___________


BOAT Name _________________________________________  Slip Number _______________

Associate Member: Associate attached to AYC Member_______________________________________


Due to printing restrictions, any Applications/Dues received after April 15, 2001, Member will NOT be 
in the printing of the AYC Directory, or have Membership Cards available on a timely basis.  Directories & 
Membership cards should be available for PICK-UP at the Harbor House, no later than June 1, 2001.

ANNUAL DUES  $150.00
Associate Dues $50.00

Make Checks Payable to:  Abbey Yacht Club


Drop off at:		Ray Engelsman		Reel-A-Tour	Slip 318		or
			Louis Carvelli		Frats Brats	Slip 305		or	
			Abbey Harbor House

OR


Mail to :		  	The Abbey Yacht Club
				c/o Ray Engelsman 
				2316 Kalamazoo Drive
				Naperville, IL  60565


Paid by:	Cash ______	  Check # ________  Date Rec’d:__________  Initial________