Whitinsville Fish & Game Club, Inc.

Club Membership Waiting List Application

Description of Club Membership Categories:

Senior Membership
(Annual fee: $145.00)
21+ Years Old. Full Membership.
10 Work Hours/Year Required.

Auxiliary Membership
(Annual fee: $25.00)
MUST BE Spouse of Senior Member.
5 Work Hours/Year Required.

Junior/Senior Membership
(Annual fee: $25.00)
16-20 Years Old. Full Membership Benefits.

Junior Membership
(Annual fee: $5.00)
1-15 Years Old. Partial Membership Benefits.

Please submit ONE FORM for each Family member Waiting List Application.
Unfortunately multiple applications are not allowed on the same submission form.

When Filling Form Below, " * " Indicates Required Fields.

*Please select the Membership Type you want to be placed on the wait for:.

Member Contact Information Below:

Please submit ONE FORM for each Family member on the Waiting List application.
Unfortunately multiple applications are not allowed on the same submission form.

First name

Last name

Mailing address

Street address line 2

City

State

Zip code

Email Address

Please Double Check Your Email Address for Correctness.

Age

Phone number

Mobile Cell Phone Number

Do You Have A Sponsor (Club Member who vouches for you**):

**If you do not have a Sponsor, please type "None".

Please Select Which Items You Currently Hold:

Please Select at least TWO (2) Volunteer Committees you would be willing to Serve on in order to gain Work Hours. May be changed later as desired or needed.

Please add any comments or notes relating to your Waiting List Application. Limit 150 Characters.

Entries above are directed to the Membership Chairman0/150

Thank You for your Interest in our Club!

We will notify you when a Membership slot opens up.

_________________________

Duration of Membership

Membership is on the Calendar year: Jan. 1 - Dec. 31. Memberships are renewed annually.