Slip Application | Island Palms Hotel Best Western Plus

Dock Your Boats And Yachts At Our Shelter Island Marina Hotel

"*" indicates required fields

Desired Move-In Date*

Personal Information

Registered / Documented Owner(s):*

Partner Name (If Applicable):

Billing Address

Street Address City State / Province / Region ZIP / Postal Code Country

Home Phone*

Business Phone

Cell Phone

Email*

Enter Email Confirm Email

Legal Owner / Lender Information

Name (Individual, Bank, Finance Co.):

Address

Street Address City State / Province / Region ZIP / Postal Code Country

Reference Agent / Loan #:

Phone

If Vessel Is Corporately Owned

State Of Incorporation:

Date

Vessel Information

Name Of Vessel:

Make/Builder:

Type

Year Built:

Length Overall:*

Beam:*

Draft

Engine

Holding Tank

Do You Have Non-Toxic Bottom Paint?

Yes

Registration or Documentation Number:

Hull:

Request Live-Aboard?*

Yes

# Of People

Pets

Present Location Of Vessel

Marina

Location

Contact Name

Phone

Do You Plan To Charter The Vessel?*

Yes

Are You Capable of Handling This Vessel In The Marina in A Safe Manner?*

Yes

Please Explain Here:

Where Did You Hear About Us?

Insurance Information

Company

Agent/Agency

Phone Number

Policy Number:

Amount Of Liability (Minimum $500,000 Required):

Exp. Date:

Utility Requirements

Electrical Voltage:

Amps:

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