Member interest Form

Please fill out the Form Below to be considered for membership of Michigan Bass Anglers or our Youth Club. Some one will contact you shortly.
Name:
Street Address:
Address (cont.):
City:
State:
Zip Code:
Cell Phone:
Home Phone:
E-mail:
BASS Number :	Enter 9 0's for Bass Number if you do not have one!
Do you own a 18 ft+ Bass Boat boat?	Yes
	No
:
Where did you hear about our club?
Your application will be reviewed and you will be contacted by someone about attending a couple of our meetings to introduce your self and meet our club members. We look forward to meeting you and hope you enjoy Bass fishing as much as we all do!
Sorry but you will have to fill in the code you see below, exactly as it appears, upper and lower case. Otherwise the form will not submit.