YACHT’S APPLICATION FORM

Full Name

Email Address

Permanent address

City

Tel

Owner OwnerCaptainRepresentative

from:

until

1. Yacht's Name

2. Flag:

3. Port of Registry and Registry number:

4. Max Length

Max Breadth

Draft

5. Grt

6. Yacht toilets lead to: A. Sewage Treatment 6. Yacht toilets lead to: A. Sewage Treatment Yes No

B. Dirty Tanks B. Dirty Tanks Yes No

C. Chem. Toilet C. Chem. Toilet Yes No

7. Volts/ Ambers needed:

8. Yacht's Year of Built.:

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