Power Application Form

Member Details

Name

First

Last

Membership Number

Boat Name

Jetty / Pen Number

Vessel Type

Power

Yacht

Power Requirements

Please find below the power classifications defined. You are required to select one of the below options which related to your intended power use: *must select from one of the following options

Type of Power Requirement

Request for an exemption to Power Charge – I do not require connection to Fremantle Sailing Club power at any point.

Casual Power Request – Defined by infrequent and irregular connection to a Club GPO. Casual Power will be charged at $30 per quarter. No connection fee is required.

Permanent Power Request – Defined as a permanent connection to a Club GPO. Permanent power will be charged a one-off $440 connection fee (unless previously paid) and subsequent quarterly usage will be charged on a sliding scale as outlined in the power connection and charging policy. The minimum quarterly charge is $117.

Please list appliances requiring power and power draw

I have previously paid the $440 connection fee

Yes

I have read and understood the power connection and charging policy and agree to the charges associated with connecting to power. I understand that power checks are conducted regularly and, should I be found to be plugged in more frequently than requested, I may be charged a higher rate in accordance with my power usage.

Yes, I have read and understood the power connection and charging policy

Signature

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