MEMBERSHIP APPLICATION

Name_______________________________________

Street_____________________________City_______________Zip_________

Phone_________________________ E-mail*__________________________

Individual Membership** $30.00 $ ________
Family Membership (family members up to age 21 in same household) $40.00 $ ________
Mailed newsletter* $15.00 $ ________
Total   $ ________

*The newsletter and other information will be sent via e-mail. If you do not have access to e-mail or prefer the newsletter mailed to you, please add $15 to the Membership Fee.

**Golden Charter Memberships are also available for a contribution of $200 or more. For information on Golden Charter Memberships and benefits, please email Steve Piper at scpiper@popmail.ucsd.edu.

Please make checks, money orders, etc. out to GOLDEN STATE
FLYCASTERS, and mail to Golden State Flycasters, 3830 Valley Center Drive, Ste. 705, Box 721, San Diego, CA 92130