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Please attach pictures of your vessel from the top, sides, and rear.
VESSEL INFORMATION
Instructions: Complete this information (attach pictures of your vessel from the top, sides, and rear) and email it to
IDENTIFICATION
Name of Vessel:
Year, Make, & Model:
Length:
Type of Vessel:
Draft:
Hull Material:
Hull and Trim Colors:
Prominent Features:
COMMUNICATION
Radio Call Sign: DSC MMSI No.:
Radio‐1 Type: Channel/Frequency Monitored:
Radio‐2 Type: Channel/Frequency Monitored:
Cell / Satellite:
Email:
PROPULSION NAVIGATION:
Primary Type: Engine: Fuel Capacity: □ Compass □ Radar □ GPS / DGPS
Auxiliary Type: Engine: Fuel Capacity: □ Charts □ Maps □ ___________
SAFETY & SURVIVAL
EPIRB UIN:
Visual Distress Signals: Audible Distress Signals:
□ Electric Distress Light (Night Only) □ Bell
□ Flag (Day Only) □ Horn
□ Flare, Aerial (day and night) □ Whistle
□ Flare, Handheld (day and night) Additional Gear:
□ Signal Mirror (day only) □ Dewatering Device □ Flashlight/Searchlight
□ Smoke (day only) □ Fire Extinguisher □ Raft / Dinghy