Sailing School Enrollment Form

Please provide the following contact information:
Name
Street address
City
State/Province
Zip/Postal code
Country
Work Phone
Home Phone
E-mail
Contact Perference	-- Select One -- Home Phone Work Phone Email

Course(s) Desired:

ASA 101 Basic Keelboat Sailing
ASA 103 Basic Coastal Cruising
ASA 104 Bareboat Charter Certification
ASA 105 Coastal Navigation
ASA 114 Cruising Catamaran
ASA 106 Advanced Coastal Cruising

ASA 101/103 Basic Keelboat Sailing & Basic Coastal Cruising Combo
ASA 103/104 Basic Coastal Cruising & Bareboat Charter Certification Combo
ASA 101/103/104 Basic Keelboat Sailing, Basic Coastal Cruising & Bareboat Charter Combo
ASA 104/114 Bareboat Charter Certification & Cruising Catamaran Combo

What is your Preferred Date to begin your class: 

Do you plan to stay aboard the teaching yacht?   Yes   No

Please briefly describe your previous sailing experience or current certification levels:

Please list student names:

What date and time do you plan to arrive? Do you require airport pickup?

Do you have any special requests or requirements?