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2024 Membership Form

J/109 Class Association



2024 Membership Form


Checks in the amount of $50.00 should be payable to "J/109 Class Association"


Print this form, update as needed, and mail with a check to:

    Julia O-Dowd
    Treasurer, J/109 Class Association
    17 Island View Avenue
    Branford, CT 06405

 

Member Type: Owner      Co-Owner      Associate Member 
 
Name: Daniel Brousseau   Email: daniel7245@gmail.com
 
Address: 109 Evergreen Ave
                 Mill Valley, CA 94941 USA
 
Phone: 4158197394   Mobile: 4158197394   Work: 4158197394
 
Boat Name: Tangaroa   Hull #: 311   Fleet #: 3 - California & Hawaii
 
Boat Homeport: San Francisco   State: CA   Country: USA
 
Boat Website or Social Media Link:
 
US Sailing #: 174676D   World Sailing #: