IBN Club Roster

Club Name: *

Club Charter Number: *

Club President Name: *

First

Last

Club President Email: *

Club Vice President Name: *

First

Last

Club Vice President Email: *

Club Secretary Name: *

First

Last

Club Secretary Email: *

Club Treasurer Name: *

First

Last

Club Treasurer Email: *

Add member #1:

Add a member to this roster.

Member 1 Name:

First

Last

Member 1 Address:

Address Line 1

City

State

Zip Code

Member 1 Phone Number:

Member 1 B.A.S.S. Number:

Member 1 Email:

Add member #2:

Add another member to this roster.

Member 2 Name:

First

Last

Member 2 Address:

Address Line 1

City

State

Zip Code

Member 2 Phone Number:

Member 2 B.A.S.S. Number:

Member 2 Email:

Add member #3:

Add another member to this roster.

Member 3 Name:

First

Last

Member 3 Address:

Address Line 1

City

State

Zip Code

Member 3 Phone Number:

Member 3 B.A.S.S. Number:

Member 3 Email:

Add member #4:

Add another member to this roster.

Member 4 Name:

First

Last

Member 4 Address:

Address Line 1

City

State

Zip Code

Member 4 Phone Number:

Member 4 B.A.S.S. Number:

Member 4 Email:

Add member #5:

Add another member to this roster.

Member 5 Name:

First

Last

Member 5 Address:

Address Line 1

City

State

Zip Code

Member 5 Phone Number:

Member 5 B.A.S.S. Number:

Member 5 Email:

Add member #6:

Add another member to this roster.

Member 6 Name:

First

Last

Member 6 Address:

Address Line 1

City

State

Zip Code

Member 6 Phone Number:

Member 6 B.A.S.S. Number:

Member 6 Email:

Add member #7:

Add another member to this roster.

Member 7 Name:

First

Last

Member 7 Address:

Address Line 1

City

State

Zip Code

Member 7 Phone Number:

Member 7 B.A.S.S. Number:

Member 7 Email:

Add member #8:

Add another member to this roster.

Member 8 Name:

First

Last

Member 8 Address:

Address Line 1

City

State

Zip Code

Member 8 Phone Number:

Member 8 B.A.S.S. Number:

Member 8 Email:

Add member #9:

Add another member to this roster.

Member 9 Name:

First

Last

Member 9 Address:

Address Line 1

City

State

Zip Code

Member 9 Phone Number:

Member 9 B.A.S.S. Number:

Member 9 Email:

Add member #10:

Add another member to this roster.

Member 10 Name:

First

Last

Member 10 Address:

Address Line 1

City

State

Zip Code

Member 10 Phone Number:

Member 10 B.A.S.S. Number:

Member 10 Email:

Additional Members:

Click or drag a file to this area to upload.

If you have additional members to add, please click here to download the roster spreadsheet template (Excel file). Upload your completed file above.

Terms & Conditions: *

I agree

1. All members give the IBN and BASS LLC and all affiliates the right to use their name and likeness in any / all media outlets. 2. As president, I certify that the information above is correct.

IBN Club Roster

Complete the form below to submit a club roster for the Illinois B.A.S.S. Nation or click here to download the roster spreadsheet template (Excel file) and upload your completed file below.