Registration Form

Applicant Details

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Name of Applicant

Address

Telephone

Fax

Mobile

E-mail

Passport/ID

Copies of passports and/or ID Cards are a pre-requisite for individual owners or vendors

Proposed Name of Yacht

(Please state at least three choices)

Proposed Name of Yacht 1

Proposed Name of Yacht 2

Proposed Name of Yacht 3

Proposed Port of Registry

Proposed Port of Registry

If Yacht is Currently Registered

Current name of Yacht

Nationality of Yacht

Select Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, the Democratic Republic of the Cook Islands Costa Rica Cote D'Ivoire Croatia Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Grand Cayman Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard Island and Mcdonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran, Islamic Republic of Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic of Korea, Republic of Kosovo Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao Macedonia, the Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova, Republic of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands Spain Sri Lanka St Barth St Croix St Maarten St Martin St Thomas Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic of Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Virgin Islands, British Virgin Islands, U.s. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe

Official Number

Port of Registry

Name and address of registered owners

Tonnage Measurement Survey

(a) Dates of availability

(b) Address where Yacht is lying

(c) Name, Tel/fax of contact

Type of Yacht

Type of Yacht

Select Type Sailing Yacht Motor sailer Open sailing boat Multihull sailing boat Classic yacht Sailing - hull only Motor Yacht Sloop RIB and inflatable boat Former professional motor boat Multihull motor boat Motor boat - hull only House boat Traditional/classic motor boat Super yacht sailing Flat and round bottom Superyacht motor Speedboat and sport cruiser Open boat Houseboat Jetski

Builders Name and Address

Builders Name and Address

Description of Yacht

Model Number or name

Yard/HIN Number

Material of Construction

Tonnage

Length

cm

Depth

cm

Breadth

cm

Estimated date of completion/delivery

Year of Build

Engine Specifications

Name and Address of Manufacturer

Year of Build

Number of engines

Number of Cylinders each engine

Diameter of each cylinder

Length of stroke

Two or Four stroke

Estimated speeds of Yacht

Serial Number of each engine

Name, address and Nationality of Vendor

Name, address and Nationality of Vendor

Insurance

Do you require an insurance quote for the yacht

We can obtain a competitive quote from our Brokers

Yes No

Radio licence

All receiving and transmitting equipment onboard requires to be licenced

Do you require a Radio Licence

Yes No

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