Transcript BAITNET.COM ENHANCED DATABASE LISTING ORDER FORM Andy Bartels BaitNet.com P.O. Box 324

BAITNET.COM ENHANCED DATABASE LISTING ORDER FORM
Please fill out the form below and send a check or money order for $10, US funds only, to:
Andy Bartels
BaitNet.com
P.O. Box 324
La Crosse, WI 54602-0324
** Please fill out the form below completely and accurately! **
Owner/Manager Name (your name will not appear on the website): _________________________________
Business name: __________________________________________________________________________
Address: _______________________________________________________________________________
City: ________________________________________
State: ___________
County: __________________________
Telephone (include area code): (_____)__________________________
Toll free number: (_____)_______________________
Zip: ____________
Fax number: (_____)_________________________
E-mail address: _____________________________________________________________________________________________
Internet address: ____________________________________________________________________________________________
Regular hours:
______________
Dates: ______________________________________________________________________
Special hours1:
______________
Dates: ______________________________________________________________________
Do you sell licenses (Y/N)? ____
Do you sell convenience items (Y/N)? _____
Miles to gas nearest station? _____
Nearby waters - names: ________________________________________________________________________________________
___________________________________________________________________________________________________________
Primary fish species nearby: ____________________________________________________________________________________
___________________________________________________________________________________________________________
Sell live bait (Y/N)? ____ Bait selection:__________________________________________________________________________
___________________________________________________________________________________________________________
Sell tackle (Y/N)? ____
Tackle selection: _______________________________________________________________________
___________________________________________________________________________________________________________