Register a Fishing Program

Complete and submit this form to add your program or event to the PFBC's web calendar.

* Required fields
# Data entered in field will be included with the web calendar listing (if yes is selected for "May we post on PFBC web site?")

PROGRAM * #

Family Fishing Program
Family Fly Fishing Program
Family Ice Fishing Program
SMART Angler Program
Fishing Derby or Rodeo
Other Program or Event	For Other Programs or Events ONLY, specify:
		Name of program or event#

		Description of program or event#

INSTRUCTOR INFORMATION
First name	Last name
Instructor number	Daytime telephone (xxx-xxx-xxxx)	E-mail address*
Address
City	State	Zip code

PROGRAM INFORMATION

Date (mm-dd-yyyy)*#

Park, lake or site*#

County*#

Start time#					Stop time#
	a.m. p.m.					a.m. p.m.

Program location (e.g.; boat house, beach, etc.)#

Street address (nearest if none)#

City#

Zip code#

Sponsor

REGISTRATION INFORMATION

Open to the Public?			Yes
			No

Pre-registration required?#			Yes
			No

If yes, contact name for registration#

Registration contact telephone (xxx-xxx-xxxx)#

Extension#

Registration contact email address#

Web site address for more information (leave blank if none)#

WEB POSTING INFORMATION

May we post on PFBC website?*

Yes

Use PFBC website for registration?# (what's this)

Yes

If yes, enter info in the 2 fields below:

Date no longer accepting registrations (mm-dd-yyyy)#

Maximum number of registrants

If no, enter registering site URL below:

Website address to register (leave blank if none)#

A confirmation message will be sent to the instructor email address provided.
After submitting this form you will be taken to the PFBC home page.