Membership Application

Tampa Bay Fly Fishing Club

Your Name: _____________________________________Date: ___________

Mailing address: _________________________________City: ____________ State: ___ Zip: ________

Hm. Phone: ____________Wk. Phone: _______________

Email address:_________________________________

Type of Membership:_________________________

Please Check: One Year________Five Year_______

Please list names you wish to include in family membership

Name:____________________ Rel: ___________
Name:____________________ Rel: ___________
Name:____________________ Rel: ___________

Annual Dues: $25.00 Individual Membership
$35.00 Family Membership
$95.00Corporate Single Membership
(includes one membership and Ad Space)
$120.00 Corporate Double Membership
(includes two memberships or family membership and
. Ad Space in Newsletter)
Five Year Dues: $100.00 Individual Membership
$140.00 Family Membership