Membership Application Form
Click here to download this form as a .pdf file

Please print this form, fill it out completely, and mail it to the address below
(Incomplete applications cannot be processed)


Please choose one of the following:

___ Basic membership (17 ages or up) $10.

___ Premium membership $25.

___ Family membership $35.

___ Standard business membership $35.

___ Premium business membership $75.

Name:_______________________________________________________________________

Spouse's  name (if family membership):______________________________________________

Mailing address:________________________________________________________________

_____________________________________________________________________________

Phone :_______________________________________________________________________

Email address:_________________________________________________________________

Please complete for all children 16 and under included in any membership 

Name:  _____________________ Age: _____       Name:  _____________________ Age: _____

Name:  _____________________ Age: _____       Name:  _____________________ Age: _____

Name:  _____________________ Age: _____       Name:  _____________________ Age: _____

Thank you for your support.

Make checks payable to "Maine Ice Anglers Association"

Mail fully completed forms and checks to: 

Maine Ice Anglers Association
PO Box 245
Lewiston, Maine 04243-0245