Your Name:	______________________________________________________________________
Name of Business:	______________________________________________________________________
Business Address:	______________________________________________________________________
City:_________________________		State:	_____	Zip:	_______
Phone:_____________________             Fax:_____________________
Website:_____________________             Email address:_____________________
Class of Membership Desired:
Brokerage Business	___	Broker	___	Associate	___
Briefly state your reason for desiring membership in GCYBA:
________________________________________________________________________________
________________________________________________________________________________
Recent marine employment history, including positions held:
________________________________________________________________________________
________________________________________________________________________________
Business references (2) including telephone numbers:
_____________________________________________			Phone:	_______________
_____________________________________________			Phone:	_______________
Sponsored by two active members:
Signature	____________________
Signature	____________________
If elected to membership in the Gulf Coast Yacht Brokers Association, I agree to abide by and conform to the Constitution, By Laws and policies of the Association.
Dates:	__________	Applicant's Signature:		_______________________
1 year $75 (Broker)		1 year $150 (House/Brokerage)		House must include pictures of location.
1 year $150 (Associate)		Enclosed Check No.		__________
Mail to: Gulf Coast Brokers Association, PO. Box 263, Seabrook, Texas 77586

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