Peterborough Fish and Game Association
Ontario

Application Form


Name:____________________ 

Address:____________________ 

City:____________________ 

P.C.:____________________ 

Phone# _____________________ 

Email:______________________ 

Family Membership $ 200.00

Senior Over 65 Years $ 180.00

Junior Membership $ 100.00

Method of Payment Check One
Cheque (   )
Money Order (   )
Master Card (   )
Card Number _________________________
Expire Date __________________________

Signatures of Sponsors Must be PF&GA Members Two Required

First Signature___________________________ Printed Name_________________________

Second Signature___________________________ Printed Name______________________

Signature of Applicant ________________________  Printed Name ____________________

This form must be submitted with the appropriate fees for presentation to the Board of Directors. It must be complete in all details. Cash will not be accepted. Make your cheque or money order payable to PETERBOROUGH FISH & GAME ASSOCIATION. Membership fees are non-refundable. NSF cheques are subject to service charges.

Return to PF&GA PO Box 241
Peterborough ON. K8J 6Y5
CUT ON THIS LINE
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