(please print, complete & mail with check)

YES, I WANT TO JOIN THE WSA!

____ $20 Individual ____ $25 Family

Name ________________________________________ Phone ____________

Email (0ptional) __________________________________________________

Street address ___________________________________________________

City ________________________________ State ______ Zip _____________

Make checks payable to: Wisconsin Smallmouth Alliance Ltd.

Mail to: Wisconsin Smallmouth Alliance Ltd.

2701 Gust Road

Verona, WI 53593