Personal Informaion

Name Date of Birth

Home
Address City State Zip Code

Business
Address City State Zip Code

Contact Information

Home Phone Work Phone Cell Phone Fax

E-mail Address Alternate E-mail Address

Equipment Informaion

Tow Vehicle
Make Model Year

Boat
Make Model Year

Motor
Make Model Year

Trolling Motor
Make Model Year

Electronics
1. Make Model 2. Make Model
3. Make Model 4. Make Model

Rods
1. Make Model 2. Make Model
3. Make Model 4. Make Model

Reels
1. Make Model 2. Make Model
3. Make Model 4. Make Model

Promotional Activity

Number of Media/Articles in which you have been featured
Last Year This Year Photos

Media type (eg. Radio, TV, Print)
1. Show/Article Name Date
2. Show/Article Name Date
3. Show/Article Name Date
4. Show/Article Name Date
5. Show/Article Name Date

Articles you have written and published
Article Title Publication Date
Article Title Publication Date
Article Title Publication Date
Article Title Publication Date
Article Title Publication Date

Public Speaking/Seminars
Event Topic Date Attendance
Event Topic Date Attendance
Event Topic Date Attendance
Event Topic Date Attendance
Event Topic Date Attendance

Number of potential customer contacts you will likely make this year
Days available for public appearances

Fishing Activity

Years Guiding/Fishing Tournaments/Guided Trips per year

Percent of Annual Income derived from Tournament Fishing/Guiding/Promoting

Tournament Series/Trails Fished
1. Series/Trail No. of Tournaments Held Tournaments Fished
Average Number of Boats Best Finish

2. Series/Trail No. of Tournaments Held Tournaments Fished
Average Number of Boats Best Finish

3. Series/Trail No. of Tournaments Held Tournaments Fished
Average Number of Boats Best Finish

4. Series/Trail No. of Tournaments Held Tournaments Fished
Average Number of Boats Best Finish

Miles driven to tournaments this year Days on the Water - Fishing/Guiding

Orgainzations or Associations in which you belong

1. Orgainzation/Association Position Held
Promotional Activity Date

2. Orgainzation/Association Position Held
Promotional Activity Date

3. Orgainzation/Association Position Held
Promotional Activity Date

4. Orgainzation/Association Position Held
Promotional Activity Date

Non Endemic Sponsors

1. 2. 3. 4.
5. 6. 7. 8.

Education Level

Highest Education Level Completed

Fishing Career Goals

Tell us your goals for your fishing career.



Tell us what you do when you are not fising - family, hobbies, other activities, etc.


References

1. Name Address
City State Zip Code

2. Name Address
City State Zip Code

Other Information

Cell Phone Service Provider Local Phone Service Provider Internet Service Provider TV/Cable Service Provider Tobacco Product Beer Liquor

TV Network Motor Oil Hunting Rifle Hunting Shotgun Hunting Bow Jean Brand Tennis Shoe Brand

Fishing Shoe Brand Sunglasses Brand Hotel Chain Gas Station Sporting Goods Retailer Fast Food Restaurant Sit Down Restaurant