NAME:______________________________________________________________________

NUMBER & STREET_________________________________________________________

CITY, STATE, ZIP ____________________________________________________________

HOME PHONE________________________ WORK PHONE________________________

E-MAIL ADDRESS___________________________________________________________

Club Memberships (Choose all that apply)			Annual Membership Dues (choose one):
Federation of Fly Fishers			Individual ($25)
Trout Unlimited			Senior (65+) ($15)
Smallmouth Alliance			Family ($30)
			Junior (<19) ($15)
Members wanting to receive the Newsletter by E-Mail please check the box to the right			Commercial ($50)
			Corporate ($250)
IS ALL THE ABOVE INFORMATION THE SAME AS LAST YEAR	YES		NO
Federation of Flyfishers who are Illinois Residents that want to be members in the SOUTHERN COUNCIL instead of the GREAT LAKES COUNCIL should check the box and initial below INITIAL________________

Please note, you must renew your Membership by December 31, 2002 to remain active in the club, receive our newsletter and insure you are included in next years Club Roster.

Also if you are a new member and you joined before September of 2002 you must renew at this time to stay active. Those joining in September or later are automatically enrolled for the following year.

Please enclose this form and a check payable to Ozark Flyfishers and mail to:

Ozark Flyfishers
Attn: Membership
P. O. Box 19753
St. Louis, MO. 63144