* All fields are required *

First name:

Last name:

Date of birth:

Phone number:

Full mailing address:

Your email:

What is your ASA ID number (if you have one)?

What is your current level of sailing experience?

Have you received training from an accredited sailing school?
YesNo
What level sailing certification do you currently hold?

What sailboats have you skippered in the last 5 years?

What wind and sea conditions do you currently sail in?

List your skills, aside from sailing, that could be useful aboard a sailboat?

Are you able to schedule (1) 4-hour volunteer day per year to help with boat maintenance and charity events?
YesNo