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2. Boater Safety Class Host Form
   If you or your organization is interested in hosting a boater safety course, please submit this form and we will contact you to make arrangements.
3. 
5. Name
6. Email Address
8. Address
10. City
11. State
12. Zip Code
14. Phone Number
15. Fax Number
17. Building Capacity:
18. Computer Projector Available?

    1. YES
    2. NO
19. Available Class Dates
    Available Class Dates Start Date

    —

    Available Class Dates End Date
21. Additional Comments:
Leave This Blank:


23. 1. Receive an email copy of this form.
24. Email address

    This field is not part of the form submission.

25. Submit

* indicates a required field