WILDSIDE B.A.S.S.

1 COBBLER’S LANE

NORTH READING, MA 01864

(978) 276-0369

                                     

APPLICATION FOR MEMBERSHIP

PLEASE PRINT

 

Name: _____________________________________________ Date of Birth: _________________

 

Address: __________________________________________ City/Town:_____________________

 

State: __________________ Zip Code: __________ Phone No.: (        ) ______________________

 

Do you currently own or have access to a boat? __________________

 

Make: _________________________ Model: _____________________ H.P. of motor: _________

 

Have you ever been a member of another fishing organization? ____________________________

If you have, please specify: __________________________________________________________

 

Have you ever been convicted of violating any game laws in any state: ____________

If you have, please specify: __________________________________________________________

 

Are you a current member of the“ Bass Anglers Sportsman Society”_______________

If so, please list your membership number: __________________ Expiration Date: ____

 

How long have you been bass fishing? _________________ Largest bass caught: ___

 

PREFERRED EQUIPMENT:

 

Rod: ___________________________ Reel: ____________________ Line strength: ____________

Lures: __________________________ Sonar Equipment: _________________________________

 

Favorite body of water: _____________________________________________________________

Favorite species of bass to fish for: ____________________________________________________

 

OPTIONAL INFORMATION:

Marital Status: ________________________________ Number of children (if any) ____________

 

If accepted as a member I willingly agree to abide by and to the present and future “Constitution and Bylaws” as well as the “Tournament Rules and Regulations” governing all members of “WILDSIDE B.A..SS.”

 

Signature: ____________________________________ Date: __________________