|
Ac-Bass-Jon’s Membership Form 2013 Season
Application / Please Print
Name__________________________________________________________
Address________________________________________________________
City/State/Zip____________________________________________________
2013 AUGUSTA COUNTY- BASS-JON’S of VIRGINIA ‘TM’
Official
Phone_________________________Cell______________________________
E-Mail__________________________________________________________
· Boater:________ Non-Boater:___________
· Boat Type:_____ HP:_____ Make:_______
· Tow Vehicle License Number:___________
· Boat VA Register Number:______________
SIGNATURE:_____________________________________________________
And PARENT, IF MINOR:_____________________________________________
If Full Membership can not be granted due to rolls being full or the Boater to Non-Boater Ratio of 2 to 1 can not be maintained with your admission. Do you wish to be placed on the Ac-Bass-Jon's Waiting List? (See By-Laws for details): Yes____ or NO ____.
Annual Dues: $30.00, Check or Money Order, Pay to the order of:
Children under the age of 16 year old Membership dues shall be $15.00, Please pay dues at the Meeting.Dues are not refundable at any time. Dues will assist in the purchase of, trophies, awards and etc.
Mail to Augusta County Bass Jon's Treasury (Blaine Fitzgerald)
Po Box 176
Mt Sidney, VA 24467
PH: 540-248-5602(home) and leave message or Doug Fitzgerald 540-910-0078
E-Mail: acbassjons@yahoo.com web site: ( www.acbassjons.net)
AUGUSTA COUNTY-BASS JONS
(www.acbassjons.net)
|
