Buck Forest Membership Application
Print Form Out, Then Fill In Each Question Completely
And Mail or Fax To:
Buck Forest
c/o Emil & Sheryl Billitz
205 Waterwood Lane
St. Augustine, Florida 32095
Fax: 904-823-3799
Please Print
Applicants Full Name: _____________________________________________Date Of Birth:__________________
Address:____________________________________________City:_____________________________________
State:______Zip Code:_____________Phone:(H)_______________________ (C)__________________________
Print Clearly E-Mail Address:_______________________________________
Type Of Employment:____________________________________________
(If Married)Spouse Full Name:__________________________________________ Date Of Birth:______________
(If Any) Number of Children: _______ Ages: ______________________________
Please Answer The Following Questions With "YES" Or "NO"
Have You Ever Been Charged With Any State Game Violations? __________
Is "QDM" Something That You Believe In? __________
Please Mark An (X) For Your Arrangements Needed If You Become A Member
Camp House/Bunk _________ Camp Site __________ Either ___________
Please Tell Us In Your Own Words Why You Would Make A Good Member At Buck Forest.
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Please Read The Statement Below And Sign If You Agree.
I have read the "Buck Forest Rules & Regulations" and I agree that if I were to become a member that I would follow
them without discord. I understand the "QDM" measures being made and I will aid in the upkeep of these.
Further more, I understand that becoming a member of Buck Forest that I will have to pay the membership dues in a
timely manner and that any violations against Buck Forest policies could result in suspension of membership without
a refund.
Signature: ____________________________________________ Date: ______________________
