2013 SOUTHERN KINGFISH ASSOCIATION MEMBERSHIP FORM
MEMBER INFORMATION Type your information on this web page and then print it out & fax it to us!
New Member Renewal Member SKA Membership #
Please Note: A Social Security number is required for prizes of $600.00 or more.
MEMBERSHIP LEVEL – (CHECK ONE)
Associate Member........... $40
Professional Tour Captain's Membership Dues........ $140
Competition Member....... $70
Competition Renewal..... $65
Competition Family**..... $90
Competition Family Renewal**.......... $85
Each primary member will receive 11 issues of our magazine - Angler - which is for SKA members only.
**Family membership includes one Primary Member plus one family member. A Family Member is a Spouse/Partner or a Child who has not
exceeded his 22nd birthday and still lives at home. Additional family members as defined are $30.00 each.
ADDITIONAL FAMILY MEMBERS
PAYMENT INFORMATION-Membership Payment Method:
Total (plus $30 per additional family member) $
Check Enclosed Check Number
Discover (Include all Digits on Credit Card)
Print Name on Card: Signature: X_____________________________
Power Mfg. by:
# of Motors:
Est. Hull Value:
When did you purchase your vessel?:
Registration Number: Trailer Manufactured by:
Are you interested in receiving a complimentary quote from our partner and tournament sponsor NBOA? Yes No
Current Marine Insurance Provider:
Return to: SKA, 15 Garnett Ave, St Augustine, FL 32084 Fax with Credit Card # to: 904-819-0331 By submitting this application for membership each person/family hereby agrees to adhere to all SKA sanctioned and SKA produced tournament rules. No refunds will be issued on memberships.
Applications are not accepted by phone. ALL MEMBERSHIPS EXPIRE 12/31/2013