Membership Application


Tampa Bay Fly Fishing Club


Your Name: _____________________________________Date: ___________


Mailing address: _________________________________City: ____________ State: ___ Zip: ________


Hm. Phone: ____________Wk. Phone: _______________


Email address:_________________________________


Type of Membership:_________________________


Please Check: One Year________Five Year_______


Please list names you wish to include in family membership


Name:____________________ Rel: ___________
Name:____________________ Rel: ___________
Name:____________________ Rel: ___________


Annual Dues: $25.00 Individual Membership
$35.00 Family Membership
$95.00Corporate Single Membership
(includes one membership and Ad Space)
$120.00 Corporate Double Membership
(includes two memberships or family membership and
. Ad Space in Newsletter)
Five Year Dues: $100.00 Individual Membership
$140.00 Family Membership

Please make check payable to: Tampa Bay Fly Fishing Club
C/o Rick Valeri, 1404 Oxfordshire Ct. Brandon, FL 33510