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FVOA Application

MEMBERSHIP APPLICATION

Representing Fishermen from Alaska to California

Room 232, West Wall Bldg.
4005 - 20th Ave. West
Seattle, WA 98199-1290
(206) 284-4720/283-7735
FAX: (206) 283-3341
http://www.fvoa.org

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Enclose Check and Mail to FVOA at the above address.
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    VESSEL NAME:_________________________________________________

    Application Date:__________________________________

    IFQ/Owner's Name:_______________________________________________

    Vessel Home Port:__________________________________

    Skipper's Name (if other than owner):____________________________

    Channel & Radio Call Ltr:__________________________________

    Owner's Permanent Mail Address:_________________________________________________

    Phone:______________________________

    City, State, Zip: ___________________________________

    Fax Number:___________________________________

    E-mail Address:___________________________________

    If Corporation

    Contact Person:_______________________________________________

    Phone:_____________________________________

     

    For Social Events:
    Spouse's Name:______________________________
    Children's names and ages:_____________________________________________________________

     

     

    TYPE OF MEMBERSHIP: (CHECK ONE)

    [ ] ACTIVE MEMBER - "ICE" VESSEL $1100.00/YEAR plus poundage assessment as voted by members

    [ ] ACTIVE MEMBER - IFQ HOLDER $550.00/YEAR plus poundage assessment as voted by members

    [ ] ACTIVE MEMBER - 'FREEZER" PROCESSOR $3100.00/YEAR includes "landing" assessments as voted by members

    [ ] ASSOCIATE MEMBER $475.00/YEAR - No assessments

    [ ] SUSTAINING SPONSOR $300.00/YEAR - No assessments

    _______________________________________________________________
    SIGNATURE
    ________________________________
    DATE

    MAKE CHECK PAYABLE TO: FISHING VESSEL OWNERS' ASSN.

    Enclose Check and Mail to :
    Room 232, West Wall Bldg.
    4005 - 20th Ave. West
    Seattle, WA 98199-1290
    (206) 284-4720/283-7735

    For Office Use Only:
    RDA____________
    TYL____________
    MCF____________
    DB____________
    DDD____________
    NWL____________