Application for Membership

Print, fill out, and return the application below with a check or money order for the membership dues to:

Mountain Laurel Chapter Trout Unlimited
1745 Regal Drive
Johnstown, PA  15904

If you choose, you may use a credit card to apply for membership or renew your membership online with National Trout Unlimited.  If you apply or renew online, please remember to include our chapter number, 040,  for which you are applying for local membership.  There are no additional dues for local membership.


Yes!   Please begin my membership to Trout Unlimited at the rate I have checked below.   I understand my dues payment entitles me to all regular membership benefits.

Name:  
Address:  
City:

 

State:

 

Zip:

 

Telephone (Day):

 

(Evening):

 

Occupation:

 

Chapter #

040 -  Mountain Laurel

Please Check Membership Category

___ Youth/Student (under 18)..$20 ___ Century.......$175
___ Senior....................$20 ___ Business......$200
___ Regular...................$35 ___ Conservator...$350
___ Family....................$50 ___ Life*....... .$750
___ Sponsor..................$100 ___ Family Life*..$850

* No further dues for Life or Family Life Members

Payment Method
Check: (Please make checks payable to:
 Mountain Laurel Chapter of Trout Unlimited)
Visa: Card #  Exp.
MasterCard: Card # Exp.
Signature