University of London Boat Club

Email Address *

First Name

Last Name

Phone Number

Trust Id No (if known)

First summer at UL (year)

the first year you rowed for UL (YYYY)

Last summer at UL

the last year you rowed for UL (YYYY)

Address (permanent address)

Street Address Address Line 2 City State/Prov/Region Postal/Zip Country

Date of Birth

day/month/year

College

Occupation

Member A= Alumnus, P=Parent, S= Student, O = Other

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