Application for Junior ● Intermediate Membership This application form is for Junior membership status (applicants under the age of 21 or full-time college students under the age of 23) and Intermediate membership status (applicants must be between the ages of 21 - 29 inclusive). After completing the form you will receive a confirmation email with an attached PDF copy of your completed application which you must sign and procure sponsorship signatures prior to submitting the application for approval. Completed applications should be returned to the BYC either via mail or in person at the club bar. Note: If you don't receive an email confirmation, please check your Junk Mail as your spam filter may have diverted the email. Step 1 of 2 50% Personal InformationApplicant Name* First Last Spouse or Domestic Partner?*Do you have a spouse or domestic partner that you wish to include on your membership?YesNoSpouse/Domestic Partner Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Phone - Home*Applicant Phone - Mobile*Spouse/Partner Phone - Mobile*Applicant Email Address* Enter Email Confirm Email OK to Email Jib Sheet Newsletter to Applicant?*YesNoSpouse/Partner Email Address Enter Email Confirm Email OK to Email Jib Sheet Newsletter to Spouse/Partner?*YesNoBirthday - Applicant*The year is not shared on the roster. Birthday - Spouse/Partner*The year is not shared on the roster. Occupation*Boat InformationBoat Owner?*You are not required to be a boat owner in order to apply for membership.YesNoBoat Type*You are not required to be a boat owner in order to apply for membership.PowerSailLength in feet*Make of Boat*Boat Name*Other InformationOther Club MembershipsName and Birthdates of dependent ChildrenPress the plus sign (+) at the right to add another dependent.NameBirthdate Applicant Badge Name*Type your name as you would like it to appear on your membership badge.Spouse/Partner Badge Name*Type your name as you would like it to appear on your membership badge.Include Boat Name on Badge?*YesNoBoat Name*Membership InformationJunior Membership in the club is for the applicant only. Intermediate Membership in the club is for the applicant and his/her immediate family (spouse/domestic partner and children). The Applicant or Parent agrees to be responsible for all family members as defined by this application, including all club charges. This application shall not be binding upon the Club until written notice of acceptance and/or membership cards(s) is/are issued by the club. Signature by Applicant confirms that he/she acknowledges Club Membership is governed by the Club By-Laws and Policies. Membership types are: ACTIVE: Applies to all applicants except for those falling into the next two categories. NON-RESIDENT: Applicant attests residency more than 50 miles away for more than sevent months/year or Canadian residents. INTERMEDATE: Applicant is between the ages of 21-29 inclusive. JUNIOR: Applicant is under the age of 21 (or 23 if a full-time student) Please Note: This form is for Junior and Intermediate applicants only. Please use the separate Membership Application for for Active/Non-Resident status if applicable.Membership Level*Please indicate the appropriate Membership level based on your current age. Junior: Up to Age 18Junior: Age 19-20 (up to 22 if Full-Time Student)Intermediate: Age 21-25Intermediate: Age 26-27Intermediate: Age 28-29 Applicant Signature: Date: Parent Signature (Junior Members under 18): Date: Applications require sponsorship by two voting members. Sponsors: By signing this application, you are acknowledging that you know the applicant sufficiently to vouch for their suitability as a member. Sponsors also agree to take an active role in welcoming and assimilating the member into the club. VOTING MEMBER SPONSORS Printed Name Signature 1. 2. Payment InfoPayment Required MEMBERSHIP CATEGORIES: JUNIOR: Members shall under the age 21 (or 23 if Full-Time Student. INTERMEDIATE: Members shall be 21 but less than 30 years of age. Category Requested Annual Dues Year Ending 9/30/2018 Dues Payable with Application Dated: Oct-Dec Jan-Mar Apr-Jun Jul-Sep Junior: Up to Age 18 $25 $25 $18.75 $12.50 $6.25 Junior: Age 19-22 $50 $50 $37.50 $25 $12.50 Intermediate: Age 21-25 $130 $130 $99 $66 $33 Intermediate: Age 26-27 $160 $160 $120 $80 $40 Intermediate: Age 28-29 $190 $190 $144 $96 $48 (Note: To inquire about alternative payment arrangements, send an email to email@example.com) Total amount to include with application: The Initiation Fee shall be waived for all incoming Junior Members. For all incoming Intermediate Members the initiation fee will be deferred. The Initiation Fee will be prorated upon application for active membership based on the By-Laws and Policies of the BYC.Junior Dues: Up to Age 18 - Oct-Dec*Application Received October-December 2017 Price: $25.00 Junior Dues: Age 19-22 - Oct-Dec*Application Received October-December 2017 Price: $50.00 Junior Dues: Up to Age 18 - Jan-Mar*Application Received January-March 2018 Price: $18.75 Junior Dues: Age 19-22 - Jan-Mar*Application Received January-March 2018 Price: $37.50 Junior Dues: Up to Age 18 - Apr-Jun*Application Received April - June 2018 Price: $12.50 Junior Dues: Age 19-22 - Apr-Jun*Application Received April - June 2018 Price: $25.00 Junior Dues: Up to 18 - Jul-Sep*Application Received July - September 2018 Price: $6.25 Junior Dues: Age 19-22 - Jul-Sep*Application Received July - September 2018 Price: $12.50 Intermediate Dues: Age 21-25 - Oct-Dec*Application Received October-December 2017 Price: $130.00 Intermediate Dues: Age 26-27 - Oct-Dec*Application Received October-December 2017 Price: $160.00 Intermediate Dues: Age 28-29 - Oct-Dec*Application Received October-December 2017 Price: $190.00 Intermediate Dues: Age 21-25 - Jan-Mar*Application Received January - March 2018 Price: $99.00 Intermediate Dues: Age 26-27 - Jan-Mar*Application Received January - March 2018 Price: $120.00 Intermediate Dues: Age 28-29 - Jan-Mar*Application Received January - March 2018 Price: $144.00 Intermediate Dues: Age 21-25 - Apr-Jun*Application Received April - June 2018 Price: $66.00 Intermediate Dues: Age 26-27 - Apr-Jun*Application Received April - June 2018 Price: $80.00 Intermediate Dues: Age 28-29 - Apr-Jun*Application Received April - June 2018 Price: $96.00 Intermediate Dues: Age 21-25 - Jul-Sep*Application Received July - September 2018 Price: $33.00 Intermediate Dues: Age 26-27 - Jul-Sep*Application Received July - September 2018 Price: $40.00 Intermediate Dues: Age 28-29 - Jul-Sep*Application Received July - September 2018 Price: $48.00 Total $0.00 Payment Type*CheckCredit Card via PayPal (PayPal account not required)Credit Card at BYC Bar (Open Tuesday-Friday evenings)Auto-Pay EnrollmentPlease enclose check made out to BYC. For payment by credit card in person, please visit the club during bar hours and attach the receipt. Mail checks to: Attn: Membership Application Bellingham Yacht Club. 2625 S. Harbor Loop Dr Bellingham, WA 98225 (360) 733-7390 Alternatively you may enroll in BYC’s Automatic Payment Arrangement (Auto-Pay). All new members are strongly encouraged to elect the Auto Pay option. If you choose this option at this time, please complete the form below. Confirm that you wish to have the total amount above charged to your bank account once you are approved for membership by initialing here__________. FOR OFFICE USE ONLY Rec'd by:____________________________________at Bar: ☐ Office: ☐ Mail: ☐ Board Approval: ☐ Posted Office: ☐ Publications: ☐ Letter: ☐ Cards: ☐ Packet: ☐ Burgee: ☐ Bellingham Yacht Club Auto-Pay Arrangement Enrollment FormThe club has set up a mechanism to allow members to pay their member account balances including bar tab, club store purchases, event payments, and certain other payments by an Electronic Funds Transfer from their bank accounts (also known as Auto-pay or ACH). In addition payment of expenses incurred by a member on behalf of the club would also be reimbursed through the same process. This should be a valuable benefit to members as there will be no more checks for members to write, mail or deposit, and it will reduce the workload on accounting and event planning volunteers. If you choose to enroll, at the end of each month you will receive an invoice for your Member Account via email from firstname.lastname@example.org which will detail your charges. You will have at least 2 weeks to review the invoice and make any inquiries regarding the charges thereon. Then on about the 15th of the month, your checking account will be charged for the amount of the invoice. To enroll please fill out the following information: Name on Account First Middle Last EmailEmail address where you want your monthly invoice sent. Enter Email Confirm Email Bank Routing NumberBank Account NumberAccount TypeCheckingSavingsI acknowledge that Bellingham Yacht Club may initiate an auto-payment from my bank account of record to satisfy monthly charges to my BYC Member Account. I agree to pay any and all charges which occur as a result of insufficient funds in my account and to notify email@example.com of any change in bank information or email address. Signature: Date: PLEASE ATTACH A VOIDED CHECK!