Form 1 800 Mcba 971 PDF Details

Navigating the waters of charter boat operations in Michigan can be as challenging as catching a prized salmon during a fishing expedition. Central to this navigational challenge is ensuring all the compasses point in the right direction, figuratively speaking, when it comes to affiliations and compliance. A key component in this journey is the 1-800-MCBA-971 form, a pivotal document for the Michigan Charter Boat Association (MCBA) members. This comprehensive application is not just a mere formality; it serves as a bridge connecting captains and mates with a wealth of benefits, including membership and internet directory listing opportunities, pivotal in steering their business towards wider horizons. With sections detailed for personal and business information, choices between new memberships or renewals, an array of charter categories to select from, and the involvement in a drug screening program, this form encapsulates critical facets of professional charter operations. Additionally, it offers options for extra visibility through secondary ports and various charter service categories, embedding flexibility and growth potential in the heart of Michigan’s charter industry. The form emphasizes compliance, operational standards, outreach, and the sense of community among charter professionals, delineating it as more than just an application, but a gateway to maintaining and elevating standards within the charter boat realm.

QuestionAnswer
Form NameForm 1 800 Mcba 971
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other names49CFR, Lienczewski, relisting, preemployment

Form Preview Example

MICHIGAN CHARTER BOAT ASSOCIATION

1-800-MCBA-971

2014 Application for Membership and Internet Directory Listing

Renew

Immediately!

On-time renewal

Applications are due

no later than

12/31/2013

(check one)

Captain Mate

(*required)

(check one) New MCBA membership MCBA membership renewal

MEMBER INFORMATION

INTERNET DIRECTORY LISTING

Name*_____________________________________________________________ Date* ________________ Check No.*__________________

Address* __________________________________________________ Business Name* ___________________________________________

City* __________________________________ State* ____ Zip* _________ Web Site: www. ________________________________________

SSN: (last four digits) XXX-XX-* _______________________________ Summer Phone* __________________________________________

USCG License Reference No.* _____________________ Exp Date* ___________ Winter Phone* ____________________________________

Date of Birth* ______________ E-Mail* __________________________________________ Cell Phone*___________________________

Vessel Documentation No. or State Registration No.* ____________________Vessel Inspected?* Yes:No:DNR:USCG:

( S p e c i f y A g e n c y )

Designated Employer Representative: IF NOT SELF ________________________________________DER Phone*____________________

The above information is required by the USCG for your annual MIS report. *Captains/Mates required to fill in business name & DER: employer

Charter Category: Fishing River Fishing Cruise/Excursion Sailing Diving Captain For Hire Other____________

Check if new Home Port: ___________________________________Lake/River ______________________________________________

Secondary Ports ($30.00 each; limit 3 per category. You must operate from the ports listed.)

1. ________________________________

2. _____________________________________

3._____________________________________

Species:

Salmon

Steelhead

Brown

Lake Trout

Walleye

Perch

Bass

Muskie

Boat Name ________________________________________________ Business Name___________________________________________

Boat Type or Brand_____________________________Boat Length ______ Boat DNR Inspected? Yes:No:USCG Inspected Yes:

Additional Charter Categories: $30 EACH Other:_____________________________________ Catch & Cook Member? Yes: No:

(Example: “Captain For Hire”, “Cruise/Excursion”,"Fishing", “River Fishing”, "Sailboat Charters", & "Dive Charters" would be separate listings.)

Make copy of form and complete for each additional category; then submit with application and payment.

 

 

 

CAPTAIN: MCBA Membership, Internet Directory Listing and MCBA Drug Screening Program

$145.00

 

 

CATEGORIES

 

CAPTAIN: MCBA Membership and MCBA Drug Screening Program

$135.00

 

 

 

MATE: MCBA Associate Membership, Internet Directory Listing and MCBA Drug Screening Program

$45.00

 

 

 

CAPTAIN: MCBA Membership and Internet Directory Listing (Must include Letter of Compliance from current drug screening Company)

$135.00

 

 

 

 

 

 

 

MEMBERSHIP

 

Pre-Employment SAMHSA Approved Drug Test (New member enrollment)

.. $55.00

 

 

 

MCBA Scholarship Fund (Donation is tax deductible)

$_____

 

 

 

MCBA Membership, Retired Captain (concluded their active membership)

$30.00

 

 

 

 

 

 

 

 

Membership $ _______ + ____ (Secondary Ports @ $30) + _____(Add’l Categories @ $30) +____ (Pre-Employment Drug Test @ $55) = $ 0.00

 

 

 

 

 

 

 

 

 

TOTAL DUE

 

 

 

 

 

 

 

“Members not renewed by January 1, 2014 will be subject to a late fee for website removal and relisting”

Check appropriate box and sign

I am currently enrolled in the MCBA Drug Screening Program

I am currently enrolling in the MCBA Drug Screening Program

I am currently enrolled in another marine industry Drug Screening Program which has not lapsed. I am excluding myself from the pre- employment SAMHSA-approved drug test (see attach L.O.C. letter).

Enclosed are the results of my pre-employment SAMHSA-approved drug test so that I may enroll in the MCBA Drug Screening Program.

I certify that the information contained in this application is true.

__________________________________________________________

Signed

Date

Check Options: (provide me with the requested information)

Water Proof Boat Emergency Checklist

MCBA Logo Decal

Drug Program Zero Tolerance Decal

MCBA Bumper Sticker

Please make check payable and return to:

MCBA Membership

38000 Castle Drive

Romulus, MI 48174

(The information on this application is subject to change without notice) 9/13