ARIZONA ANGLERS FAMILY FISHING CLUB MEMBERSHIP ®   APPLICATION FOR MEMBERSHIP  Name: __________________________________ Spouse: _____________________ Address: ___________________________ City:  _____________ Zip: ____________  Home # ___________________________ Cell # _____________________________  E-mail address: ________________________________________________________  Child Name: _______________________________ Date of Birth: ________________ Child Name: _______________________________ Date of Birth: ________________ Child Name: _______________________________ Date of Birth: ________________ Child Name: _______________________________ Date of Birth: ________________  Auto Insurance Company Name: ___________________________________________ Auto Insurance Company Policy Number: ____________________________________  Boat Insurance Company Name: ___________________________________________ Boat Insurance Company Policy Number: ____________________________________  Emergency Contact Information: ____________________Phone # _______________  Single Membership ($40.00)  _________  Family Membership ($55.00)  ___________  Date Paid: __________________ Renewal Date: ___________________   Who referred you: (how did you hear about us) ________________________________ _______________________________________________________________________   Please send application to: Charlotte Grissom 8961 W. Stella Ave Glendale, Arizona 85053 Print membership form just click on the fish