Marine Queensland - formerly BIAQ > PRODUCTS > BOATCLUB

Join Boat Club

Complete the form below to lodge your Boat Club membership application now.

Your Personal Details

Title:

Surname:

Given Names:

Home Address Line 1:

Home Address Line 2:

Suburb:

State:

Postcode:

Mailing Address (if different to above):

Mailing Address Line 2:

Suburb:

State:

Postcode:

Home Phone:

Work Phone:

Mobile Phone:

Email Address:

Your Boat Details

Vessel Length (metres):

Name of Vessel:

Registration Number:

Vessel Construction:

Hull Colour:

Deck Colour:

The vessel moves under::

Sail
Inboard Power
Outboard Power

Horsepower:

Membership Type:

Payment Details

your credit card number will be collected via phone
please complete the rest of the form below

Please debit my:

Bankcard
Visa Card
Master Card

Card Expiry Date:

Cardholder's Name:

Cardholder's Address:

Contact Phone Number: