CREW BUREAUX REGISTRATION FORM

(CRUISING AND TRAINING)

Completion of this form implies agreement to hold this data on computer for CSSA use only.

Personal Details
Name CSSA Membership no
Address

 

 CSSC Membership no
E-mail Address
CS Department
Home telephone Work telephone

Previous Sailing Experience (please just tick or state no. of years/seasons as appropriate):

Number of years Age if under 25 years
Sailing Dinghies Inland I have sailed as
Sailing Dinghies at Sea Skipper
Yachts Inland Navigator
Yachts at Sea Mate
Racing Inland Watchkeeper
Racing at Sea Racing crew
Power boats Inland Sailing crew
Power boats at Sea Other
Use of a spinnaker on a dinghy/yacht

RYA Certificates Held (please just tick if date or certificate number not known):

Delete either/or, if not appropriate:
Shorebased Dayskipper/Watchleader date
Shorebased Coastal Skipper/Yachtmaster date
Day Skipper / Coastal Skipper Practical date
Coastal Skipper / Yachtmaster Offshore Examination date
   

Cert no

Shorebased / Practical - Yachtmaster Ocean

date

    Cert no
Other RYA Certificates, types, dates, and Cert. nos (eg Dinghy Level 1/2, VHF, First Aid):-

 

Yacht Sailing - Areas of Interest ( please send to first choice area contact):

S. Coast - e-mail Andy Smith at csdseatime@yahoo.co.uk for details
E. Coast - John Miller, 70 Park Avenue, Birchington, Kent, CT7 0DL
CSORC - Trevor Drew, 110 St Johns Road, Woking, Surrey, GU21 1PS
NW Coast - John Murray, 11 Cromfield, Ashton, Ormskirk, Lancs, L39 5AB

Yacht Sailing - Types Desired (please tick appropriate items):

Introductory Daysail RYA Competent Crew Practical Course
Introductory Cruise RYA Day Skipper Course
Seatime Cruise RYA Coastal Skipper Course
Other Courses RYA Yachtmaster Preparation Course
Private Charter (Approved skippers) RYA Coastal Skipper/Yachtmaster Exam

Notes (eg preferred months of year/areas):

Date Signed

Print This Form

This form is to be mailed to the appropriate person listed above.