Print Name:____________________________ Phone:________________
Print Address:________________________________________________
City:________________ State:_________________ Zip:______________
E-Mail:____________________ Date of Birth:_______________________
Name of additional students
________________________________________Date of Birth:__________
________________________________________Date of Birth:__________
________________________________________Date of Birth:__________

Select:

• Class Date(s): ____________________
• Class Location: ___________________
• Class Type: ______________________

Deposit Requirements:

[  ]  Safe Boating Basics $25.00
[  ]  GPS/Chartplotters $25.00
[  ]  Radar $25.00
[  ]  Basic Coastal Navigation 25.00
[  ]  Advanced Coastal Navigation 25.00

[  ]  Captain's License (OUPV) 200.00
[  ]  Master 100 GT License 200.00
[  ]  Master 100 GT Upgrade License 100.00
[  ]  Launch Operator's License 100.00

Refund Policy: Students will forfeit their deposit if cancellations or reschedules are made within 14 days of the start of class.

PLEASE CALL 800-698-7373 TO CONFIRM SEAT AVAILABILITY BEFORE SENDING ANY DEPOSIT.

Boatwise, LLC
72 Woodman Rd.
So. Hampton, NH. 03827
Tel: 800-698-7373
Fax: 603-394-0418
E-Mail: captains@boatwise.com