Want to join Lee County Professional Guides Association? Print out the form below, fill it out, and send it to the address below with the appropriate fee.
Lee County Professional Guides Association
A Non-Profit Organization
Membership Application
Date: __________________
Name: ______________
_______________________ _______________________ _____
Capt., Mr., Mrs.,
Ms.
Last
Name
First
Name
MI
Address: _________________________________________________________
City: _____________________ State: ____________ Zip Code: ____________
Home Phone: (____) ______________ Business Phone: (____) _____________
Cell: (____) __________ Pager: (____) __________ Fax: (____) ___________
Email Address: ____________________________________________________
Website (if Captain): ______________________________________________________
Type of Membership: ______________ Amt.
Enclosed: $_______ Ck. #: _____
(Guide, Angler, Corporate)
Membership
Fees: Guide - $50.00 | Angler - $25.00 | Corporate:
$250.00
Below for Guide Applications Only
Boat Information
Make: ____________ Length: ________
Type: _______________ H.P.: ______
(Flats, Skiff, C.C., Sport fish, etc)
Fishing Information
Max. # of People: ____ Fishing Area: _____________ Fishing
Type: ___________
(Back Bay, Flats, Offshore) (Spin, Fly, Wrecks, Reefs,
Trolling)
I presently hold a current Coast Guard License (NUMBER: _____________), State of Florida Commercial Saltwater Fishing License and maintain commercial insurance $______________(dollar amount) in Liability Coverage. (If Captain, attach Coast Guard License, Occupational License, Saltwater vessel license & Insurance Certificate).
X_________________________________
Signature of
Guide
Below for Corporate Applicants Only
Corporation Name: _________________________________________________
Address: _________________________________________________________
City: _____________________ State: ____________ Zip Code: ____________
New Membership _____
Membership Renewal
| Make checks payable to: Lee County Professional Guides Association |
Please remit payment to:
17544 Lebanon Road
Fort Myers, FL 33967
|
| *June 1st - Membership Fees Due | *June 30th - Grace period expires -
removed from web site ($15.00 processing fee to put back on). |
Revised 12-2008