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NYC Membership Application
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Thanks for your interest in becoming a member of the Nanaimo Yacht Club.
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Applicant First Name
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Applicant Last Name
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Home Address
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City
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Province
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Postal Code
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Home Phone
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Cell Phone
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Business Phone
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Email Address
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Date of Birth
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Spouse/Partner (If Applicable) First Name
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Spouse/Partner (If Applicable) Last Name
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Spouse/Partner (If Applicable) Email Address
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Spouse/Partner (If Applicable) Cell Phone
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Spouse/Partner (If Applicable) Business Phone
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Club Sponsor Name (if applicable)
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