B.A.S.S. Nation (adult) Club Affiliation
Fill out the first 5 entries and then fill out information for the amount of members you have in your club. Instead of having to scroll to the bottom you can press "enter/return" after completing the final members information to submit the form.
Club Name or Number *
Your answer
List the state you are affiliating with *
Your answer
Club President Name *
Your answer
Club President Email *
Your answer
Club Secretary Name *
Your answer
Club Secretary Email *
Your answer
Member 1 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 1 First Name
Your answer
Member 1 Last Name
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Member 1 Address
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Member 1 City
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Member 1 State
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Member 1 Zip
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Member 1 Email
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Member 1 Phone
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Member 2 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 2 First Name
Your answer
Member 2 Last Name
Your answer
Member 2 Address
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Member 2 City
Your answer
Member 2 State
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Member 2 Zip
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Member 2 Email
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Member 2 Phone
Your answer
Member 3 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 3 First Name
Your answer
Member 3 Last Name
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Member 3 Address
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Member 3 City
Your answer
Member 3 State
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Member 3 Zip
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Member 3 Email
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Member 3 Phone
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Member 4 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 4 First Name
Your answer
Member 4 Last Name
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Member 4 Address
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Member 4 City
Your answer
Member 4 State
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Member 4 Zip
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Member 4 Email
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Member 4 Phone
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Member 5 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 5 First Name
Your answer
Member 5 Last Name
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Member 5 Address
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Member 5 City
Your answer
Member 5 State
Your answer
Member 5 Zip
Your answer
Member 5 Email
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Member 5 Phone
Your answer
Member 6 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 6 First Name
Your answer
Member 6 Last Name
Your answer
Member 6 Address
Your answer
Member 6 City
Your answer
Member 6 State
Your answer
Member 6 Zip
Your answer
Member 6 Email
Your answer
Member 6 Phone
Your answer
Member 7 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 7 First Name
Your answer
Member 7 Last Name
Your answer
Member 7 Address
Your answer
Member 7 City
Your answer
Member 7 State
Your answer
Member 7 Zip
Your answer
Member 7 Email
Your answer
Member 7 Phone
Your answer
Member 8 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 8 First Name
Your answer
Member 8 Last Name
Your answer
Member 8 Address
Your answer
Member 8 City
Your answer
Member 8 State
Your answer
Member 8 Zip
Your answer
Member 8 Email
Your answer
Member 8 Phone
Your answer
Member 9 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 9 First Name
Your answer
Member 9 Last Name
Your answer
Member 9 Address
Your answer
Member 9 City
Your answer
Member 9 State
Your answer
Member 9 Zip
Your answer
Member 9 Email
Your answer
Member 9 Phone
Your answer
Member 10 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 10 First Name
Your answer
Member 10 Last Name
Your answer
Member 10 Address
Your answer
Member 10 City
Your answer
Member 10 State
Your answer
Member 10 Zip
Your answer
Member 10 Email
Your answer
Member 10 Phone
Your answer
Member 11 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 11 First Name
Your answer
Member 11 Last Name
Your answer
Member 11 Address
Your answer
Member 11 City
Your answer
Member 11 State
Your answer
Member 11 Zip
Your answer
Member 11 Email
Your answer
Member 11 Phone
Your answer
Member 12 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 12 First Name
Your answer
Member 12 Last Name
Your answer
Member 12 Address
Your answer
Member 12 City
Your answer
Member 12 State
Your answer
Member 12 Zip
Your answer
Member 12 Email
Your answer
Member 12 Phone
Your answer
Member 13 BASS Member Number
Your answer
Member 13 First Name
Your answer
Member 13 Last Name
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 13 Address
Your answer
Member 13 City
Your answer
Member 13 State
Your answer
Member 13 Zip
Your answer
Member 13 Email
Your answer
Member 13 Phone
Your answer
Member 14 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 14 First Name
Your answer
Member 14 Last Name
Your answer
Member 14 Address
Your answer
Member 14 City
Your answer
Member 14 State
Your answer
Member 14 Zip
Your answer
Member 14 Email
Your answer
Member 14 Phone
Your answer
Member 15 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 15 First Name
Your answer
Member 15 Last Name
Your answer
Member 15 Address
Your answer
Member 15 City
Your answer
Member 15 State
Your answer
Member 15 Zip
Your answer
Member 15 Email
Your answer
Member 15 Phone
Your answer
Member 16 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 16 First Name
Your answer
Member 16 Last Name
Your answer
Member 16 Address
Your answer
Member 16 City
Your answer
Member 16 State
Your answer
Member 16 Zip
Your answer
Member 16 Email
Your answer
Member 16 Phone
Your answer
Member 17 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 17 First Name
Your answer
Member 17 Last Name
Your answer
Member 17 Address
Your answer
Member 17 City
Your answer
Member 17 State
Your answer
Member 17 Zip
Your answer
Member 17 Email
Your answer
Member 17 Phone
Your answer
Member 18 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 18 First Name
Your answer
Member 18 Last Name
Your answer
Member 18 Address
Your answer
Member 18 City
Your answer
Member 18 State
Your answer
Member 18 Zip
Your answer
Member 18 Email
Your answer
Member 18 Phone
Your answer
Member 19 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 19 First Name
Your answer
Member 19 Last Name
Your answer
Member 19 Address
Your answer
Member 19 City
Your answer
Member 19 State
Your answer
Member 19 Zip
Your answer
Member 19 Email
Your answer
Member 19 Phone
Your answer
Member 20 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 20 First Name
Your answer
Member 20 Last Name
Your answer
Member 20 Address
Your answer
Member 20 City
Your answer
Member 20 State
Your answer
Member 20 Zip
Your answer
Member 20 Email
Your answer
Member 20 Phone
Your answer
Member 21 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 21 First Name
Your answer
Member 21 Last Name
Your answer
Member 21 Address
Your answer
Member 21 City
Your answer
Member 21 State
Your answer
Member 21 Zip
Your answer
Member 21 Email
Your answer
Member 21 Phone
Your answer
Member 22 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 22 First Name
Your answer
Member 22 Last Name
Your answer
Member 22 Address
Your answer
Member 22 City
Your answer
Member 22 State
Your answer
Member 22 Zip
Your answer
Member 22 Email
Your answer
Member 22 Phone
Your answer
Member 23 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 23 First Name
Your answer
Member 23 Last Name
Your answer
Member 23 Address
Your answer
Member 23 City
Your answer
Member 23 State
Your answer
Member 23 Zip
Your answer
Member 23 Email
Your answer
Member 23 Phone
Your answer
Member 24 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 24 First Name
Your answer
Member 24 Last Name
Your answer
Member 24 Address
Your answer
Member 24 City
Your answer
Member 24 State
Your answer
Member 24 Zip
Your answer
Member 24 Email
Your answer
Member 24 Phone
Your answer
Member 25 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 25 First Name
Your answer
Member 25 Last Name
Your answer
Member 25 Address
Your answer
Member 25 City
Your answer
Member 25 State
Your answer
Member 25 Zip
Your answer
Member 25 Email
Your answer
Member 25 Phone
Your answer
Member 26 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 26 First Name
Your answer
Member 26 Last Name
Your answer
Member 26 Address
Your answer
Member 26 City
Your answer
Member 26 State
Your answer
Member 26 Zip
Your answer
Member 26 Email
Your answer
Member 26 Phone
Your answer
Member 27 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 27 First Name
Your answer
Member 27 Last Name
Your answer
Member 27 Address
Your answer
Member 27 City
Your answer
Member 27 State
Your answer
Member 27 Zip
Your answer
Member 27 Email
Your answer
Member 27 Phone
Your answer
Member 28 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 28 First Name
Your answer
Member 28 Last Name
Your answer
Member 28 Address
Your answer
Member 28 City
Your answer
Member 28 State
Your answer
Member 28 Zip
Your answer
Member 28 Email
Your answer
Member 28 Phone
Your answer
Member 29 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 29 First Name
Your answer
Member 29 Last Name
Your answer
Member 29 Address
Your answer
Member 29 City
Your answer
Member 29 State
Your answer
Member 29 Zip
Your answer
Member 29 Email
Your answer
Member 29 Phone
Your answer
Member 30 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 30 First Name
Your answer
Member 30 Last Name
Your answer
Member 30 Address
Your answer
Member 30 City
Your answer
Member 30 State
Your answer
Member 30 Zip
Your answer
Member 30 Email
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Member 30 Phone
Your answer
Member 31 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 31 First Name
Your answer
Member 31 Last Name
Your answer
Member 31 Address
Your answer
Member 31 City
Your answer
Member 31 State
Your answer
Member 31 Zip
Your answer
Member 31 Email
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Member 31 Phone
Your answer
Member 32 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 32 First Name
Your answer
Member 32 Last Name
Your answer
Member 32 Address
Your answer
Member 32 City
Your answer
Member 32 State
Your answer
Member 32 Zip
Your answer
Member 32 Email
Your answer
Member 32 Phone
Your answer
Member 33 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 33 First Name
Your answer
Member 33 Last Name
Your answer
Member 33 Address
Your answer
Member 33 City
Your answer
Member 33 State
Your answer
Member 33 Zip
Your answer
Member 33 Email
Your answer
Member 33 Phone
Your answer
Member 34 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 34 First Name
Your answer
Member 34 Last Name
Your answer
Member 34 Address
Your answer
Member 34 City
Your answer
Member 34 State
Your answer
Member 34 Zip
Your answer
Member 34 Email
Your answer
Member 34 Phone
Your answer
Member 35 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 35 First Name
Your answer
Member 35 Last Name
Your answer
Member 35 Address
Your answer
Member 35 City
Your answer
Member 35 State
Your answer
Member 35 Zip
Your answer
Member 35 Email
Your answer
Member 35 Phone
Your answer
Member 36 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 36 First Name
Your answer
Member 36 Last Name
Your answer
Member 36 Address
Your answer
Member 36 City
Your answer
Member 36 State
Your answer
Member 36 Zip
Your answer
Member 36 Email
Your answer
Member 36 Phone
Your answer
Member 37 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 37 First Name
Your answer
Member 37 Last Name
Your answer
Member 37 Address
Your answer
Member 37 City
Your answer
Member 37 State
Your answer
Member 37 Zip
Your answer
Member 37 Email
Your answer
Member 37 Phone
Your answer
Member 38 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 38 First Name
Your answer
Member 38 Last Name
Your answer
Member 38 Address
Your answer
Member 38 City
Your answer
Member 38 State
Your answer
Member 38 Zip
Your answer
Member 38 Email
Your answer
Member 38 Phone
Your answer
Member 39 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 39 First Name
Your answer
Member 39 Last Name
Your answer
Member 39 Address
Your answer
Member 39 City
Your answer
Member 39 State
Your answer
Member 39 Zip
Your answer
Member 39 Email
Your answer
Member 39 Phone
Your answer
Member 40 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 40 First Name
Your answer
Member 40 Last Name
Your answer
Member 40 Address
Your answer
Member 40 City
Your answer
Member 40 State
Your answer
Member 40 Zip
Your answer
Member 40 Email
Your answer
Member 40 Phone
Your answer
Member 41 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 41 First Name
Your answer
Member 41 Last Name
Your answer
Member 41 Address
Your answer
Member 41 City
Your answer
Member 41 State
Your answer
Member 41 Zip
Your answer
Member 41 Email
Your answer
Member 41 Phone
Your answer
Member 42 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 42 First Name
Your answer
Member 42 Last Name
Your answer
Member 42 Address
Your answer
Member 42 City
Your answer
Member 42 State
Your answer
Member 42 Zip
Your answer
Member 42 Email
Your answer
Member 42 Phone
Your answer
Member 43 BASS Member Number
Your answer
Member 43 First Name
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 43 Last Name
Your answer
Member 43 Address
Your answer
Member 43 City
Your answer
Member 43 State
Your answer
Member 43 Zip
Your answer
Member 43 Email
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Member 43 Phone
Your answer
Member 44 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 44 First Name
Your answer
Member 44 Last Name
Your answer
Member 44 Address
Your answer
Member 44 City
Your answer
Member 44 State
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Member 44 Zip
Your answer
Member 44 Email
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Member 44 Phone
Your answer
Member 45 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 45 First Name
Your answer
Member 45 Last Name
Your answer
Member 45 Address
Your answer
Member 45 City
Your answer
Member 45 State
Your answer
Member 45 Zip
Your answer
Member 45 Email
Your answer
Member 45 Phone
Your answer
Member 46 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 46 First Name
Your answer
Member 46 Last Name
Your answer
Member 46 Address
Your answer
Member 46 City
Your answer
Member 46 State
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Member 46 Zip
Your answer
Member 46 Email
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Member 46 Phone
Your answer
Member 47 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 47 First Name
Your answer
Member 47 Last Name
Your answer
Member 47 Address
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Member 47 City
Your answer
Member 47 State
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Member 47 Zip
Your answer
Member 47 Email
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Member 47 Phone
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Member 48 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 48 First Name
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Member 48 Last Name
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Member 48 Address
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Member 48 City
Your answer
Member 48 State
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Member 48 Zip
Your answer
Member 48 Email
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Member 48 Phone
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Member 49 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 49 First Name
Your answer
Member 49 Last Name
Your answer
Member 49 Address
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Member 49 City
Your answer
Member 49 State
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Member 49 Zip
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Member 49 Email
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Member 49 Phone
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Member 50 BASS Member Number
If you do not have or know your BASS Member Number, you can leave this blank.
Your answer
Member 50 First Name
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Member 50 Last Name
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Member 50 Address
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Member 50 City
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Member 50 State
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Member 50 Zip
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