If you are interested in becoming a member of First Bassmasters of Sullivan County, please print out, then complete the form below and mail your application to the address below. Applications are being considered on a first come, first serve basis. We will contact you with further information regarding annual dues, meeting schedules, etc.
Name:
Date of Birth:
Day: � � � �Moth: � � � �Year:�
B.A.S.S.#:
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Address:
City:
State:
Zip:
Phone:
Fax:
E-Mail:
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Boat:
Yes������� No � � � If yes, complete the following:
Manufacturer:
Model/Length:
Engine Make/HP:
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Prior Club:
Yes������� No����� If yes, complete the following:
Club Name:
From: � � � � � � �To:
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How did you hear about 1st. Bassmasters of Sullivan County?
