Salmon Master Institute Registration Form

Thanks for your interest in Salmon Master Institute fishing schools.

To mail registration please print out this page, fill it out and return with your payment to the address listed below.

Salmon Master Institute
Captain Chip Porter
740 Summit Road
Lake Zurich, IL 60047
847-726-8877
E-mail: chip@chipporter.com

Attendee #1

Name:_____________________________ Phone:___________________

Address:_______________________________________

Town, State, Zip:________________________________

Attendee #2

Name:_____________________________ Phone:___________________

Address:_______________________________________

Town, State, Zip:________________________________

Attendee #3

Name:_____________________________ Phone:____________________

Address:_______________________________________

Town, State, Zip:________________________________

Please enclose a check (or fill out Credit Card information) in the amount of $95 for each attendee. Confirmations with directions and school itinerary will be mailed within 2 weeks of receipt of paid registration.

AMOUNT Of CHECK ENCLOSED: $___________

CREDIT CARD #:_________________________________  EXP DATE _______  AMOUNT TO BE CHARGED TO CARD:_________

NAME ON CARD__________________________________  SIGNATURE____________________________________________

Please check the box of the Salmon Master Institute you wish to attend:

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