Nation's Capitol Bass Federation

 Membership Application   

  Personal Information                                                   

    Name (first)      (last)

     Address           

     City, State Zip     

     Phone Number   

                  e-mail   

          Occupation  

    Federation Information                                                 

      FLW membership number (required) Must Be a member

            Other fishing organizations you are a member of 

       Membership type

       Full $75.00    Associate $25    Youth $5 

   Boat Information (if boater):                                               

       Make     Length    H.P.    

      By signing this application for membership I agree to adhere to the By-Laws of the NCBF

        Signature    Date 

       Print this application and mail with appropriate fees  to:  

John Sisson - 2509 Brown Farm Court - Brookville MD - 20833