Rogue Flyfishers Membership Form

Contact Information:

Your Name:_________________________

If Family Membership, names of other members:____________________________________

Address:__________________________________________________________________

Telephone, Home:____________________

Work:____________________

Cell:___________________ E-Mail Address:____________________________________


Payment (checks only) enclosed for:

_____Regular Membership $30.00/year

_____Family Membership $35.00/year

_____Youth Member (18 & under) $5.00/year



Please note: All memberships are renewable on January 1st of each year. New members joining prior to June 30th will pay a full year's dues, while anyone joining after June 30th will pay one-half of the current rates.



Questionare:

Please select from this columnLet us know what your interests are
___New Membership___Acquire more knowledge
___Renewal___Find a fishing partner
___Former Member___Help with conservation projects
___Address Change___Improve fishing techniques
___Contribution___Social functions
 ___Other (use back for notes)
Drift Boat? _______ Other Boat? _______


Please mail the completed form to: Rogue Flyfishers, PO Box 4637, Medford, OR 97501