First Name: - Required

Last Name: - Required

Mailing Address - Street address: 

Mailing Address - City: State: Zip:

Primary Contact Phone: - Required

Phone 2:

Phone 3:

E-mail Address: - Required (if you have one)
 
Do you own a boat (yes/no)?

If yes, what type and size is it?
Type (motor, sail, personal watercraft): Size:

If no, what type and size boat are you considering purchasing?
Type (motor, sail, personal watercraft): Size:

What type of boating activity describes you best (Personal Watercraft (PWC) Use; Fishing Sailing Protected Waters; Sailing Open Wates; Cruising Protected Waters; Cruising Open Waters; Waterskiing/Wakeboarding/Tubing)?:

List any and all experience with recreational boating - be specific:

How many years experience do you have?

Would you be interested in learning more about the Coast Guard Auxiliary? YES No

What class or classes are you signing up for? REQUIRED - You MUST Select at Least One

America's Boating Class (ABC)

Advanced Coastal Navigation

Boating Skills and Seamanship (BS&S)

GPS for Mariners