New York Sailing School

Coastal Navigation Enrollment Form

First Name
Last Name
Address
City, State, Zip Code
E-mail (required)
Day Phone
Evening Phone

Coastal Navigation	Schedule / Dates
Total Cost $200	Call 914 235 6052 to schedule exam.

Please fill the Information and press submit button.

Credit Card	VISA MASTERCARD DISCOVER AMEX DINERS
Account No.
Expiration Date - MM/YY

Remarks / Additions:
Dear NYSS

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