Cinosam Club Boat Slip Wait List Application Form
Name_______________________Spouse_________________
Cinosam address_____________________________________
Home address _______________________________________
Phone (1)_________________________(2) _______________
Email (1)__________________________(2)__________________
Purchase date of Cinosam property________________________
Do you rent or lease your property to or from others___________
A copy of your Crow Wing County tax statement or other document showing property ownership must accompany this application. Failure to comply with this request may delay the addition of your name to the Boat Slip Waiting List. * A $100 deposit must accompany this application form. If the application is denied the deposit will be returned.
Signature___________________________________
Date_______________________________________
Please return this form to:
Cinosam Club/Boat Committee
Attn: Ginny
PO Box 2851
Baxter, MN 56425 form revised 5/15/20 (gw)
