YACHT CLUBS OF MARYLAND

YACHT CLUBS OF MARYLAND

Directory Information form

Please print, complete, and submit the following form to:

R/C Lou Konopacki, 123 Bayside Drive, Baltimore, MD 21222 - (410) 282-5598

Please provide the following for the person submitting this form for the member club:

Name: ___________________________________________________________
Address: _________________________________________________________

City/State/Zip code: ________________________________________________
Phone Number: ____________________________________________________
E-mail address: ____________________________________________________

Provide the following for your club:

Name of Club: ____________________________________________________
Address of Club: __________________________________________________

City/State/Zip code: ________________________________________________
Phone number of club: ______________________________________________
Directions to Club by Land: __________________________________________

___________________________________________________________________

Directions to club by boat: _____________________________________________

___________________________________________________________________

Provide the following information for the Commodore:

Name: _____________________________________________________

Address: ___________________________________________________

___________________________________________________

Phone: __________________________(Home)

__________________________(Cell)

__________________________(Work)

Email: (1)__________________________________________________

(2)__________________________________________________

Provide the following information for the Vice Commodore:

Name: ____________________________________________________

Address: ___________________________________________________

___________________________________________________

Phone: __________________________(Home)

__________________________(Cell)

__________________________(Work)

Email: (1)__________________________________________________

(2)__________________________________________________

Provide the following Information for the Rear Commodore:

Name: ____________________________________________________

Address: ___________________________________________________

___________________________________________________

Phone: __________________________(Home)

__________________________(Cell)

__________________________(Work)

Email: (1)__________________________________________________

(2)__________________________________________________

Provide the following Information for the Fleet Captain:

Name: _____________________________________________________

Address: ___________________________________________________

___________________________________________________

Phone: __________________________(Home)

__________________________(Cell)

__________________________(Work)

Email: (1)__________________________________________________

(2)__________________________________________________

Provide the following information for the Secretary:

Name: ____________________________________________________

Address: ___________________________________________________

___________________________________________________

Phone: __________________________(Home)

__________________________(Cell)

__________________________(Work)

Email: (1)__________________________________________________

(2)__________________________________________________

Provide the following information for the Treasurer:

Name: ____________________________________________________

Address: ___________________________________________________

___________________________________________________

Phone: __________________________(Home)

__________________________(Cell)

__________________________(Work)

Email: (1)__________________________________________________

(2)__________________________________________________

Provide the following information for the YCM alternate representative:

Name: _____________________________________________________

Address: ___________________________________________________

___________________________________________________

Phone: __________________________(Home)

__________________________(Cell)

__________________________(Work)

Email: (1)__________________________________________________

(2)__________________________________________________

Provide the name of the Princess for 2005:

Name: _____________________________________________________

Address: ___________________________________________________

___________________________________________________

Phone: __________________________(Home)

__________________________(Cell)

__________________________(Work)

Email: (1)__________________________________________________

(2)__________________________________________________

Please provide the following information for Opening Day in 2006:

· Date: ________________________________________________

· Time of Opening Ceremony: ____________________

· Location of Ceremony: _________________________________________

· Date of any opening Dinner/Dance for 2006: ____________________

· Time of any opening Dinner/Dance: _________________________

· Name of Contact at your club regarding 2006 Opening events:

o Name: ________________________________________

o Phone Number: _____________________________

Provide the following regarding the next Commodores Ball:

· Date: ________________________________

· Time: ______________________________________

· Location: ___________________________________________

· Name of Contact: ____________________________________

· Phone Number of Contact: _______________________

Provide other events that you want publicized for 2005:

· Name of Event: ___________________________________

· Date: ________________________________

· Time: ______________________________________

· Location: ___________________________________________

· Name of Contact: ____________________________________

· Phone Number of Contact: _______________________

· Name of Event: ____________________________________

· Date: ________________________________________

· Time: ______________________________________

· Location: _______________________________________

· Name of Contact: ____________________________________

· Phone Number of Contact: _______________________________

· Name of Event: ____________________________________

· Date: ________________________________________

· Time: ______________________________________

· Location: _______________________________________

· Name of Contact: ____________________________________

· Phone Number of Contact: _______________________________

· Name of Event: ____________________________________

· Date: ________________________________________

· Time: ______________________________________

· Location: _______________________________________

· Name of Contact: ____________________________________

· Phone Number of Contact: _______________________________

· Name of Event: ____________________________________

· Date: ________________________________________

· Time: ______________________________________

· Location: _______________________________________

· Name of Contact: ____________________________________

· Phone Number of Contact: _______________________________

· Name of Event: ____________________________________

· Date: ________________________________________

· Time: ______________________________________

· Location: _______________________________________

· Name of Contact: ____________________________________

· Phone Number of Contact: _______________________________

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