Use Request : SSTV Der Pelikan
This is a request to use the SSTV Der Pelikan.  Approval is required by the FOSSOM Board.  
Sign in to Google to save your progress. Learn more
Email *
Ship Number *
Ship City & State *
Skipper/Point Of Contact Last Name *
Skipper/Point Of Contact First Name *
Skipper/Point of Contact Phone Number *
Arrival Date *
MM
/
DD
/
YYYY
Arrival Time *
Time
:
Departure Date *
MM
/
DD
/
YYYY
Departure Time *
Time
:
Purpose of Cruise *
I acknowledge this is only a request, and that FOSSOM will notify me when the request is approved. I acknowledge a FOSSOM Skipper must be aboard to use the boat. *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy