Boater Application

Fields marked with * are required.

Application Type *

New ($10.00) Replacement ($5.00)

First Name *

Middle Name

Last Name *

Birth Date *

Height *

Gender *

Male Female Nonbinary

Hair Color *

Eye Color *

Phone

The address entered on your application is the address your card will be mailed to.

Country *

Mailing Address Line 1 *

Mailing Address Line 2

Zip/Postal Code *

City *

State/Province/Region *

Email *

Confirm Email *

Please ensure your e-mail address is correct. Your temporary boater card will be mailed to the address you provide.