MAIL IN MEMBERSHIP FORM

Mail in membership form

Name: ________________________________________

Street Address, __________________________________________________________

City, ______________________________________________________________

State,_____________________________________________

Zip code:______________

Home/Cell Phone:_______________________

E-Mail Address:________________________________

TBF Membership Number (if already a member of TBF):__________________________

What will it cost to join TBFKS?

TBF National annual dues $50

TBFKS annual dues $30

(First time TBFKS member – TBFKS annual dues free)

Total Annual Dues $80

Send this form with a check or money order to:

TBFKS Membership
Attn: Ray Hillebrand
1345 Cheyenne St., Leavenworth, Ks 66048

Agreement and Signature________________________________________

By submitting this membership form, I affirm that I am requesting membership into the TBFKS and TBF (National). I

further agree to uphold the values of youth, conservation, and sportsmanship as set forth in the bylaws of the TBFKS.

Name (printed):__________________________________

Signature:_______________________________

Date:________________________________________