NYFTTA MEMBERSHIP APPLICATION

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 Full Membership - $150.00 (Fishing Tackle Trades Only)

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 Associate Member - $100.00 (Non-Voting Status)
 

Name:_________________________________________

Title:_________________________________________

Company/Organization:______________________________

Street Address:___________________________________

City:_________________________ State:____________

Zip Code:__ __ __ __ __ - __ __ __ __

Work Phone:(     ) __ __ __- __ __ __ __  (Ext.)__________

Fax Number:(     ) __ __ __- __ __ __ __

E-mail Address:__________________________________

URL: http://www. __________________________________
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Please print this application and send it along with your payment to:

NYFTTA * PO Box 3210 * Patchogue, NY 11772