INTERNATIONAL FEDERATION OF BLACK BASS ANGLERS

532 Gatsby N.W. Concord, NC 28027

TELEPHONE (704) 784-4348

ARTHUR BRONSON, PRESIDENT, CEO

HANNES LINDEQUE, VICE PRESIDENT

IFBBA MEMBERSHIP APPLICATION

NAME (please print) ________________________________________________________

ADDRESS _______________________________________________________________

CITY _________________________________ STATE _______ ZIP CODE _________

TEL ( ) ___________________ WORK ( ) ____________________________

DATE OF BIRTH ____/____/____ SEX: MALE ____________ FEMALE ________

DATE ____________________ SIGNATURE __________________________________

BOAT OWNERS:

BOAT MAKE AND MODEL __________________________________________________

MOTOR MAKE AND MODEL ________________________________________________

LENGTH ____________________________ HORSEPOWER ___________________

MEMBERSHIP PAYABLE BY CHECK OR MONEY ORDER TO THE IFBBA

______ One Year Membership @ $20.00

______ Multiple Year Membership x $20.00 = $ ________

______ Lifetime Membership @ $300.00 per person

MAIL YOUR IFBBA COMPLETED MEMBERSHIP APPLICATION AND PAYMENT TO:

ARTHUR BRONSON, PRESIDENT

IFBBA

532 Gatsby N.W. Concord, NC 28027

THE IFBBA……. ALWAYS FISHIN