Southern Cross/Gillmer Owner Association (SCOA)
Welcome Aboard - New Membership Application
Joining SCOA is easy. Just fill out this form, make a check payable to SCOA and send it to our
Secretary/Treasurer at the address below. Dont worry if all the info is complete. They will provide you
a new member packet which includes the latest newsletter and member directory along with the
details on how to access the members web site and more. To speed things up you may want to send
an email indicating your interest first as we might be out sailing !

If you have any questions about joining SCOA drop an email to the Commodore too.
Welcome Aboard.  
Secretary/Treasurer;  
Deborah Duggan
Attn: SCOA
115 Upland Road
Concord, MA 01742

Deborah_Duggan@hotmail.com
For more information email  SCOA contact the Commodore at Deborah_Duggan@hotmail.com
Annual Membership and renewal fees are $25.00
 

Please make checks payable to SCOA  
Name(s) _________________________________________________________
Address _________________________________________________________
City ____________________________  State ________   Zip ______
Country ______________________________
Home Phone ________________Work/Cell Phone _______________________
Email ___________________________________________________________
Electronic Delivery Only of the Newsletter? (No paper copy)      Y/N __

Boat Name _______________________________________________________

Radio Call Sign Amateur/Commercial __________________________________

Home/Hailing Port _________________________________________________

Southern Cross or Gillmer ______   Length ____39   ____35  ____ 31 ____28  

Hull Color _______________ Deck Color______________Sail Number _______

Rig: cutter/sloop________ Factory or Owner Finish _______________________

Significant Modifications ____________________________________________

Hull #_____________________________

Hull Identification Number (This is stamped into the hull on the starboard stern area just below the rubrail.
It begins with the letters CER followed by a series of letters and numbers.

Previously Owned Info (if available) _________________________________________

Significant Cruises______________________________________________________

Planned Cruises________________________________________________________