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CFFA Membership Form

Fill out this form then click on your browser's print button.
Mail completed form and payment to:
Connecticut Fly Fishermen's Association, Inc.
P.O. Box 380268
East Hartford CT 06138-0268

Date:

Check box if address changed
New Member
Membership renewal

Name:

 

Street:

 

Street(cont):

City/State/Zip:

 

Tel. Home/Work:

 

Email:

 

Please check a committee you are now on or wish to be on:

 
  Conservation   Program
  Education   Publicity
  Fund Raising   Banquet
  Secretarial Duties   Indoor Facilities

Dues Structure:

  Junior (under 16) $5.00  
  Regular $20.00  
  Supporting $30.00  
  Contributing $75.00  
  Life $300.00  
 

Total Enclosed:


 Make Checks Payable To: "CFFA"

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Logo  Connecticut Fly Fishermen's Association, Inc.
P.O. Box 380268
East Hartford CT 06138-0268