If you are a Christian and would like to become a member, please print this page and send the completed application to:

Miss-Lou Christian Fishing Club

c/o Dave Hickman

1596 Hwy. 569

Ferriday, LA 71334

                                                                                Date:             /          /            

Miss-Lou Christian Fishing Club

Membership Application

Name:                                                                                                                    

Mailing Address:                                                                                                 

City:                                                     State:                   Zip Code:                    

Phone: (Area Code:                   )                      –                                                 

Email:                                                                                                                    

Are you a Christian? Yes                       No                 

If yes, please explain how you became a Christian and your current relationship with Jesus Christ:

Church currently attending:                                                                               

$30 membership dues paid? Yes                       No