REGISTRATION FORM BILL'S MUSKY CLUB

Your registration form must be received (post marked) by the 10th of the month following your catch and all blanks must be filled in that have a star* to qualify for any monthly/yearly awards.

Send to:  Bill's Musky Club Inc., P.O. Box 476, Schofield, WI 54476

Please fill out form legibly to avoid information being missed or recorded incorrectly

Type of Member*

Reg Member______ Master________Guide_______Woman_______Junior______

Condition of fish*

Kept_______Released______Length______________________

Name*___________________________________________________________________

Address*_________________________________________________________________

City*____________________________________State*________________Zip*_________

Date Caught*____________Time*____________  AM  PM  (please circle one)

Length*______________________Weight_______________Girth____________________

Bait Manufacturer__________________________________________________

Type of bait (please circle one)

Surface    Jerk    Crank    Glider    Twitch    Buck Tail    Spinner bait    Jig    Rubber    Other

Wisconsin Caught Fish

Lake________________________________County*______________________________

Out of State Caught Fish

Lake Caught_________________________ State / Providence*______________________

Witness_________________________________________________________(signature)

Member_________________________________________________________(signature)