Membership Application


THE LAKELAND BASSMASTERS
MEMBERSHIP  APPLICATION FORM
First Name:    
Last Name:    
Street Address:    
City/Zip Code:    
Contact Numbers
Home:    
Work:    
Cell:    
Your Email:    
   
BASS   #*    
STATUS Boater       
   
  BOATERS ONLY
BOAT: Make/Year Size:  Engine HP:
  Insurance:** Carrier:
Expiration date of current policy:   
 
   
  SIGNATURE DATE: Example: 2006-12-12
   
   
   
  Club bylaws require membership in BASS
   
  ** Club bylaws require boaters have minimum $300,000 liability insurance policy. A copy of the policy must be submitted with this application
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