Bloomington-Normal Bass Club Membership Form

Name:                                                     Date of Birth:                                    New Member           Renewal             

Address:                                                                         City:                                            Zip                                     

Phone:                                          Cell Phone:                                         

Email Address:                                                                                                                                                             

Signature:                                                                             Date:                                                                                 

Memberships are $20/year and includes the BNBC Newsletter and/or club information via email.  Please complete the form and return to membership director or any board member.  Club meetings are held the first Wednesday of every month at Miller Park Pavilion, 7:00PM.

Mail Address:  PO Box 3461 Bloomington, IL 61701

Membership questions:  Jamie Maisenbacher 309-310-3700 or  bnbassclub@yahoo.com.

Please indicate if your would like to receive information via email or newsletter by circling one of the options below.

                                                                            Newsletter        Email