Ladies, Let's Go Fishing
Local Chapter Membership Application

Please print and complete this membership form and then contact the Chapter Leader in your area to find out where to forward your membership form and payment.

Personal Information

Name:_______________________________________

Address: _____________________________________

City , State,Zip:________________________________

Business Name: ____________________________

Date of Birth : _____________

I have taken a class before? Yes / No


Home Phone: (_____)______________________

Work Phone: (_____)______________________

Cell Phone: (_____)______________________

Fax Number: (_____)______________________

Email: _________________@__________________

Chapter Membership

Association Membership with Chapter Privileges

Please circle which chapter you are joining:

* Ft. Lauderdale *Southwest FL/ Naples *Palm Beaches

Please check one:

___$35 Local & National Association

___$25 MID-YEAR SPECIAL FOR NEW MEMBERS JOINING AFTER JULY 1, Renewable Dec. 31

 
Payment Information

 

Payment: ____Check#________________ _____Money Order