EmailMe Form - Able2sail Volunteer Form

Name *

First Last

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country

Date of Birth *

Phone *

Email *

Emergency Contact Name *

Emergency Contact Phone Number *

Disability (yes / no)? *

if yes, can you provide details

*

Please tick here if you would be willing to help with fundraising

Experience of sailing (tick appropriate box) *

None

Beginner

Intermediate

Advanced

Experience of powerboating (tick appropriate box) *

None

Beginner

Intermediate

Advanced

Sailing miles completed *

any further information about sailing- miles/ hours etc...in what capacity you have sailed, as skipper/ crew) In what conditions you have sailed- day/ night)

Qualifications (RYA) (tick as appropriate) *

Please provide certificate numbers and issued by here *

Other qualifications (tick as appropriate)

further information on other qualifications (RYA)

any other qualifications (non-RYA)

By ticking this box you acknowledge that all the information you have provided on this form is true to the best of your knowledge and you are interested in becoming a volunteer with able2sail