BOAT-PAC Application

If you are interested in contributing to the BOAT-PAC,
please print out and return this application along with your personal check to:

BOAT-PAC
1269 Bassett Road
Westlake, OH 44145

Today's Date _______________

Your Name _____________________________________________________ 

Street Address ________________________________________________ 

Address Line 2 ________________________________________________ 

City ___________________________ State _________ Zip __________ 


---------------------------------------------------------------


Here is my contribution to the future of recreational boating.
(Please check the appropriate space)

___ $25      ___ $50      ___ $100      ___ $____


Here is my Gift Choice:

$25 Contribution (select one):  ___ BAO Bag	  ___ Travel Mug

$50 Contribution (select one):  ___ Boating Cap	  ___ Golf Shirt
													  (S, M, L, XL, XXL)

$100 Contribution:  Select any two of the above choices.



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