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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Click here to pay by C.C.

dotbl.jpg (629 bytes) Additional Contributions:.

dotbl.jpg (629 bytes) Please specify the committee you wish
     additional contributions to be applied:  
___ $10.00   ___ Reef Replenishment Committee
___ $25.00   ___ Sportfishing Education Center
___ $50.00   ___ Rod and Reel Loaner Programs
___ $75.00   ___ Scouting Partnership Committee
___ $100.00 ___ Political Action
___ Other    ___ Fish-A-Thon Contest
___ "Kids" Fishing Projects

Please print this application and send it along with your payment to:

NYFTTA * PO Box 3210 * Patchogue, NY 11772

 


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