First Name:                               Last Name:

Street Address:         City:

State: Select State Michigan Ohio                        Zip:

Business Phone:      Home Phone:       Cell Phone:

Best Time To Call:

Boat Make:                                         Model:

Power or Sail:  Select Power Sail                     Length:                         Color:

State Registration:          Home Port:

Boat Name:

Package Of Interest: Select Package Fisherman $50 Regional $80 Unlimited $95

Comments:

This information is not considered a contract until such time as you are contacted by Captain Don or one of his appointed representatives and it has been paid in full.

I have read the above statement: Yes No  

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