Street:
City:
State: ZIP:
Phone:
E-mail:
I am interested in joining as:
An individual member ($25) Family membership ($35)
Please indicate which areas you would be willing to provide help (check all that apply): Plan a program. Plan an outing. Provide refreshments. Teach flyfishing or flytying. Contribute to the newsletter.
Please list two preferred meeting days and meeting places:
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