| LOS PESCADORES FLY FISHING CLUB MEMBERSHIP APPLICATION |
| Copy and Print off the Application
2009 Annual Dues $200
Print - Complete - Mail with your check to LPFFC
c/o Ken Dettelbach, President
223 N Guadalupe St., #159, Santa Fe, NM 87501
If you have trouble getting on to this page or printing it,
let us know by e-mailing pams@lpffc.com.
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APPLICATION TO JOIN LOS PESCADORES FLY FISHING CLUB
Thank you for your interest in the Los Pescadores Fly Fishing Club. Your membership to LPFFC includes
your spouse or partner. Please fill out this application in its entirety.
I, ____________________________________________________________, hereby apply for membership
in the Los Pescadores Fly Fishing Club (“LPFFC”).
(Please PRINT clearly or type)
Name ___________________________________________E-mail____________________________________
Phone (h) (_____) _________________ (w) (_______) _________________ (c) (_____) _______________
Spouse/Partner_______________________________E-mail________________________________________
Phone (h) (_____) _________________(w) (_______) _________________ (c) (_____) _______________
Mailing Address ________________________________________________________________________________________
City, State, ZIP _________________________________________________________________________________________
Your Occupation _______________________ If retired, your past occupation ________________________
Spouse’s Occupation ____________________ If retired, their past occupation________________________
I would like to serve on the following committee(s):
___ Conservation — Protect and improve New Mexico fisheries through work projects, education
and political activism
___ Youth — Organize, schedule, promote, and expand the reach of the LPFFC’s youth education
classes
___ Mentor Program — provide members who have the desire to learn how to fly fish confidence
by assisting them on the river (this is not a guided program)
Age Group (check one) ___ 20-29, ___ 30-39, ___ 40-49, ___ 50-59, ___ 60-69, ___ 70+
The information provided shall be held confidential and only used for LPFFC membership
committee and roster purposes.
COMPLETE AND MAIL ALONG WITH YOUR CHECK MADE PAYABLE TO LPFFC.
2009 ANNUAL MEMBERSHIP $200
MAIL TO: LPFFC
C/O KEN DETTELBACH
223 N. GUADALUPE #159
SANTA FE, NM 87501
__________________________________________________________ _____________________________
APPLICANT SIGNATURE DATE
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