Address-Information Update Form

MEMBERSHIP AND ADDRESS UPDATE FORM
* Indicates required Information

Member Name	B.A.S.S. Number (9 digit)
*	Required*

Reason for Update:*
New Member to Add (you must fill the form out, PRINT it and Mail it along with a check, to BASS)	Change of Information for an Existing Member
Re-instatement of a Member Previously on the Roster	Change in Club Office/Position
Removal of Member from our Club Roster

PREVIOUS INFORMATION (Please fill in as much as possible)
Club Name	B.A.S.S. Club Number
*	Adult Club Youth Club
Address	City	State	Zip Code

Email Address	Phone Number	Cell Phone

President Secretary Member

NEW INFORMATION: Mark the box next to the areas with NEW INFORMATION
Club Name	B.A.S.S. Club Number

Address	City	State	Zip Code

Email Address	Phone Number	Cell Phone

President Secretary Member

(a) Submitting this form on the M.B.C.F Website will only ensure the information is updated at the Michigan B.A.S.S. Chapter Federation level. See the information below to submit at the National B.A.S.S. level.

INFORMATION SHOULD BE SENT TO:
1. Submit a copy to your Club's Membership Person (PRINT the form to submit)
2. Submit to the B.A.S.S Federation**	3. Submit to the Michigan B.A.S.S. Federation*
A) Mail To: (PRINT the form to submit, when adding a member) B.A.S.S. Federation Federation Department PO Box 420235 Palm Coast, FL 32142-0235	A) Mail To: (PRINT the form to submit) Michigan BASS Chapter Federation Membership Director Sharon Leonardi 23405 Deanhurst Clinton Twp. MI 48035
B) You may submit an update via the Web Site at: B.A.S.S. Member Services	B) You may Submit an information change via the Web Site at: http://www.michiganbass.net
C) Fax To: (PRINT the form to submit when you are only changing information) 1-407 566-2436 Any questions can be directed to Patty Morsc at BASS at 1-877-BASSUSA	Any questions may be directed to Sharon Leonardi at MBCF at 586-567-1709

**NOTE: Your Club Membership Person may do this for you, check with them before submitting.