New Membership Application Form

We are so happy to see you are interested in becoming a member or modifying your membership to include the "Step-Up" or "Junior" level membership at our Club, the Genesee County Fish & Game Protective Association (aka Godfrey's Pond). Please complete the below form choosing the level you need and submit with payment. If you have any questions, please reach out to us at 585-815-1545.

Name *

Address, City, State, Zip Code *

Date of Birth: *

Email *

Phone *

Occupation: *

Place Employed: *

Marital Status: *

Spouse's Name: *

Phone *

Boys under 18:

Birthdate:

Girls under 18:

Birthdate:

Boys under 18:

Birthdate:

Girls under 18:

Birthdate:

Boys under 18:

Birthdate:

Girls under 18:

Birthdate:

Please list three (3) Character References with Name/Address/Phone/Email *

Sponsored for membership by: Name/Address/Phone/Email (Must be a current member.) *

0/35 characters

Note: Membership Application will be acted upon at next General Membership Meeting after receipt of same. Applicant will be notified as to acceptance or rejection.

Check One: *

Senior (New) Membership

Junior Membership

Step-Up Membership

Membership Fees: *

Senior (New) Membership & Initiation ($254.00+$11.00 svc/late fee)

Junior Membership ($33.00+$2.25 +$11.00 svc/late fee)

Step-Up Membership ($154.00+$6.95+$11.00 svc/late fee)

Current Total: (Press Calculate)

$0.00