Membership Application

My Application for Membership is:

New  

Renewal
Family Membership* Yes   No
Type of Individual Membership: 1 Yr($25)   2 YR($50)   3 YR($75)   Life($200)
If yes, total number joining:  

*Family Membership: Father/Mother/Son/Daughter living in same household.  Dues are $25.00 for the first member, $7.00 for each additional member per year.  Maximum age for child is 17 years, 18 and older must join as a regular member.
Boat Owner or Rider?
First Name:

 
Last Name:  
Suffix:
Social Security #:
Address:
City:
State:
Zip Code:
Phone:
E-Mail:
Partners Name:
Other Family Members Joining Today:
  Name   Date of Birth (if child)
1.  
2.  
3.  
Are you in a Bass Club? Yes   No
Name of Club:

Method of Payment: Check/Money Order**Payable to: American Bass Association PA & NJ

Print this page and mail along with your check to the address below.

Please send payments to:
Please send payment to: American Bass Association PA & NJ                                      
191 Pumpkin Hill Rd.
Glenmoore, PA  19343-1516
(484) 356-5570