2021 FFFC MEMBERSHIP APPLICATION
NAME(s): Please list names as you want them to appear on Membership Badge 1. __________________________________ Primary Member 2. __________________________________ Spouse 3. __________________________________ Relationship ___________________ 4. __________________________________ Relationship ___________________ Note: Membership badges will be retained and distributed at club meetings. Retired: Yes ____ No ____ If No, please List Occupation _________________________ NEW MEMBER Yes ____ No ____ ADDRESS: _______________________________________________________________ CITY: _____________________ STATE: ________ ZIP: _______________________ PHONE: ________________________ E-MAIL: _________________________________ Please note that all contact information above must be completed Family (2 or more) ……….………………….….. $25.00 __________ (Can include partner & children under 18 years old) Adult (18 to 64 years) …………………………… $20.00 __________ Senior Membership (65 years +) ………………. $15.00 __________ (Can include partner) Junior Membership (under 18 years) … ………. $10.00 __________ Life Membership (Can include partner) ………. $500.00 __________ Additional Conservation Donation (Optional)………. __________ Total Due………………………………………………. __________ Payment can be processed at club meetings or mail the completed form, along with a check, payable to: FFFC (Fly Fishers for Conservation) 100 E. Sierra PMB 3310 Fresno, CA 93710 |