Please fill out the attached application form and return it by mail to the address shown on the application form, along with a refundable $200 application fee. If you are accepted, the $200 will be applied to the required initiation fee, and you will have 30 days to pay your club dues. If you are not accepted into the club, the $200 will be refunded to you. If you have any questions you can e-mail Amy Cooper, Membership Chair. Email: click HERE

Tiverton Yacht Club

I/We make application for membership in the Tiverton Yacht Club.

This application is made and taken, and if accepted, will be accepted, upon the following conditions:

This application will not be binding on the Tiverton Yacht Club until the membership committee and the board of Directors have accepted the applicant. This applicant, if accepted for membership, agrees to observe and to abide by all rules and regulations made, enacted and promulgated for the guidance and conduct of the Tiverton Yacht Club. Each member is entitled to all privileges and benefits of the club, conditioned upon observation and obedience of the club's by-laws and house rules.

Application Fee: $200.00 Refundable, to be submitted with application. If accepted, will be applied toward Initiation fee for new Members which is currently $500.00.

Participation Assessment Fee; $100.00 (annual) creditable toward next years annual dues if the amount and quality of participation are considered satisfactory by one of the TYC committee chairpersons (currently a minimum of 6-8 hours)

I. Membership Classes; There are four classes of membership:

1. Family Membership; annual dues $400.00 (applicant having a spouse or significant other living in same household with children living with applicant or children not living with applicant but children will use club facilities)

2. Couple Membership; annual dues $300.00 (applicant having a spouse or significant other living in same household with no children living with applicant or children not living with applicant but children will not use club facilities)

3. Single Membership; annual dues $200.00 – (applicant is single, not married or living with a significant other and with no children)

4. Senior Citizen Membership; annual dues $200.00 – (applicant is 65 years old or older with at least 10 consecutive years of TYC membership in good standing. Single or a couple, with or without children and/or grandchildren)

State type of membership desired: ___________________________________

State reasons for joining the club: _______________________________________

________________________________________________________________________________________________________________________________________

What do you feel you can offer or bring to the club, if accepted? _______________

________________________________________________________________________________________________________________________________________

I. Personal Information

Applicant

Name: ___________________________________________________________
Address: _________________________________________________________
City: _______________________________ State: __________ Zip: __________
Home Telephone: _________________ Work Telephone: ___________________
e-mail Address: ____________________________________________________
Fax:___________________________ Cell phone:________________________

Co-Applicant

Name: ___________________________________________________________
Relationship to Applicant, if any: _______________________________________
Address: _________________________________________________________
City: _______________________________ State: __________ Zip: __________
Home Telephone: __________________ Work Telephone: __________________
e-mail Address: ____________________________________________________
Fax:____________________________ Cell: phone________________________

Children

Name: ______________________________________ Date of Birth: __________
Name: ______________________________________ Date of Birth: __________
Name: ______________________________________ Date of Birth: __________
Name: ______________________________________ Date of Birth: __________

III. Business/Profession

Employer (applicant): _______________________________________________
Type of business: ___________________________________________________
City: ________________________________ State: ____________
Zip: __________ Phone: _________________________
Occupation/Title: ________________________________________________
Employer (spouse/significant other): _____________________________________
Type of business ___________________________________________________
City: ________________________________ State: ____________ Zip: _______
Phone: _____________________Occupation/Title: ________________________

IV. Other Club Affiliations

Please list affiliations with other private clubs of which you are now or have been a member. Indicate the address and period of membership in each.
1. _________________________________________________________________
2. _________________________________________________________________
3. _________________________________________________________________
4. _________________________________________________________________

Have you ever been refused membership, suspended, expelled, or requested to withdraw a proposal for membership in a club or other organization?
[ ] Yes [ ] No If "yes," explain the reason:
__________________________________________________________________________________________________

Have you ever voluntarily withdrawn from consideration for membership at any club or organization?
[ ] Yes [ ] No If "yes," explain the reason:
__________________________________________________________________________________________________
Proposed TYC Membership Application 2004_page 3 of 3 rev. 6/8/04

V. Club Association

List the members of the club with whom you, or co-applicant, is personally acquainted:

Name:____________________________ Relationship: _____________________
Name:____________________________ Relationship: _____________________
Name:____________________________Relationship: _____________________

List names of any relatives who are or have been members of the club:

Name:_____________________________ Relationship: ____________________
Name: ___________________________ Relationship: _____________________
Name: ___________________________ Relationship: _____________________

VI. Interests

Do you own a boat? ____ Type/Class: _______________ Length: __________
Name: _____________________Mooring or dock location: _________________

In which of the following activities do you or your family plan to participate?

______Cruising ______Sailboat racing ______Sail training
______Social activities ______Swimming lessons ______Youth activities

About which , if any, of the following activities would you like additional information?

______Cruising ______Sailboat racing ______Sail training
______Social activities ______Swimming lessons ______Youth activities

How do you plan to satisfy the participation requirement?

Cruise Committee______Race Committee_______Sail Training Committee_______
Social Committee________Junior Activties Committee__________House Committee_______

[ ] Membership Committee [ ] Marina Committee [ ]  Finance Committee

Terms: Application fee $200.00 must accompany application. Refundable if not accepted.

Upon acceptance, balance of Initiation fee, membership dues, and first year participation assessment fee are due 30 days after billing. Representations or promises not contained herein are not a part of this application and the TYC organization accepts no responsibility for any undertaking or understanding not contained, and the club will not be bound. All checks must be made payable to the order of Tiverton Yacht Club and mailed to The Tiverton Yacht Club, P.O. box 54, Tiverton, RI 02878

Signed_____________________________________________

Applicant

Signed_____________________________________________

Co-Applicant