Women's Surf fishing Club of nj

AffadaviT

Species: __________________________  Length:____________________  Girth:____________________

Beach Where Caught: ___________________________________________________________________

Date: (MM/DD/YY)  _____________________________

Caught By: ___________________________________________________________________________

Witness: ______________________________________  Phone: (________)_______________________

Address: _____________________________________________________________________________

Within Thirty (30) days of catch, Send to Flo Pancoast, 183 Winding Brook Run, North Wales, PA  19454

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Women's Surf fishing Club of nj

AffadaviT

Species: __________________________  Length:____________________  Girth:____________________

Beach Where Caught: ___________________________________________________________________

Date: (MM/DD/YY)  _____________________________

Caught By: ___________________________________________________________________________

Witness: ______________________________________  Phone: (________)_______________________

Address: _____________________________________________________________________________

Within Thirty (30) days of catch, Send to Flo Pancoast, 183 Winding Brook Run, North Wales, PA  19454