KELLY CREEK FLYCASTERS

Membership Application

PLEASE PRINT

Name_________________________________________________    Date________________

Street_________________________________________________    Phone_______________

City/State/Zip___________________________________________    Year________________  

E-Mail________________________________________________

Individual Dues:  $35.00 per year

Family Dues:  $40.00 per year

Mail to:  KELLY CREEK FLYCASTERS

P.O. BOX 2131, LEWISTON ID 83501

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