Great Lakes Sport Fisherman Membership Application Please fill out this form and we will get in touch with you shortly. Name:* First Last Address:* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Name of Boat:Home Phone:*Cell Phone:Email:* Spouse's Name:Company Name:Website: Number of people in household:Membership: New Membership Renewal Membership Change of address Please check all that apply.Membership Type: Family Membership - $20 Junior Membership - $20 Senior Membership - over 65 - $20 Associate Membership - See Levels Below Associate Membership Levels: Silver - $100 Gold - $200 Platinum - $500 Titanium - $1000 and more * Associate Memberships are for our Business Partners * Silver Membership gets a 1 line entry in our Newsletter * Gold Membership gets 1 Business Card in our Newsletter * Platinum Membership gets 1/4 page ad in our Newsletter * Titanium Membership gets 1/2 page ad or more in our NewsletterDo you give permission to share your personal contact information with other GLSF members?* Yes No We have an electronic directory and need to have your approval to share your contact information with the other GLSF members.I am a Charter Captain: Yes No Captcha