Utah Bass Federation Associate Member Application

First Name:_________________________________________________

Last Name:_________________________________________________

Street Address:______________________________________________

City:_________________________ State:__________ Zip:___________

Home Phone:__________________ Work Phone:___________________

E-Mail:_____________________________________________________

Are you a member of FLW ?      YES      NO

FLW Member # :___________________

Are you interested in joining FLW * ?                  YES         NO 

Are you interested in joining a local club ?                YES         NO

I understand that by becoming an Associate Member of the Utah Bass Federation, I’ll be eligible to attend all Utah Bass Federation functions. As an Associate Member I will NOT be eligible for the Utah Bass Federation State Team***.

Signed:_____________________________________________ Date:________________

 *   FLW is a national organization dedicated to bass fishing and publishes FLW Outdoors Magazine. The magazine covers bass fishing and FLW tournaments. Membership is $25.00 a year.

 *** To be eligible for the Utah Bass Federation State Team you must be a member of FLW and a member of an affiliated club that is in good standing with the Utah Bass Federation.

q       Utah Bass Federation Associate Membership        $15.00

q       Utah Bass Federation Membership + TBF Membership + FLW Membership        $15.00 + $15.00 + $25.00 = $55.00