WWW.HARVESTERBASS.COM
2008 HARVESTER BASS CLUB MEMBERSHIP APPLICATION
DATE:_______________
NAME (please
print)_________________________________________
Street Address
_____________________________________________
City_________________________State____________Zip__________
Home Phone MEMBERSHIP STATUS
Work Phone Regular
Cell Phone Youth
Email Address
Member Signature____________________________________
PLEASE NOTE: YOUR MEMBERSHIP APPLICATION AND FEES MUST BE
RECEIVED BY THE SECRETARY/TREASURER SEVEN (7) DAYS PRIOR TO
FISHING YOUR FIRST CLUB TOURNAMENT. THERE ARE NO
EXCEPTIONS TO THIS RULE, SO ALLOW PLENTY OF TIME
FOR TRANSIT AND PROCESSING YOUR NEW MEMBERSHIP OR RENEWAL .
Make $20.00 check payable to Harvester Bass Club and send to:
CHRIS MARTIN
114
W. 21st Avenue
Coal Valley, Ill. 61240
(IF JOINING/RENEWING BY MAIL PLEASE ENCLOSE A SELF ADDRESSED/STAMPED ENVELOPE TO RECEIVE YOUR MEMBERSHIP CARD)
************DO NOT FILL OUT LOWER
PORTION*********************************************
TREASURER INITIALS______________
PAID : YES
NO
DATE RECEIVED: ________________
MEMBERSHIP NO.
____________