Atlantic Kayak Association Application for Membership:

 Name:____________________________________________________________

Individual or Family: (Circle one) Number of Applicants:_________

Address:_________________________________________________________

________________________________________________________________

Telephone # Home:________________________________________________

                  Work:________________________________________________

E-mail address: __________________________________________________

Level of paddling experience: (Circle one) Beginner; Intermediate; Experienced; Advanced

How did you hear about the AKA?_______________________________________


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