Mid-South Walleyes
Membership Application
Your membership includes two colorful club logo decals for your vehicle or boat, a club patch, a quarterly club newsletter and a club membership card good for reduced tournament entry fees.  Please enclose this form along with your check or money order payable to:

Mid-South Walleyes
3440 State Hwy KK
Rogersville, MO  65742
MEMBERSHIPS:
INDIVIDUAL = $30.00 per year
FAMILY (2 members at the same address) = $35.00 per year
First Name(s):
Address 1:
City:
Zip:
Phone:
Last Name:
Address 2:
State:
E-mail Address:
Please print the completed form and mail along with payment to:

Mid-South Walleyes
3440 State Hwy KK
Rogersville, MO  65742
Signature:_________________________________Date:_____/_____/_____
I prefer to receive the newsletter via email:
I would like to help MSW in the following manner: Check all that apply
Writing Articles for the Website or Newsletter
Representing MSW at Sport Shows
Conducting Seminars
Event Planning
Publicity
Marketing
Conducting Tournaments
Yes
No