Complete this form, print it out and mail it complete with signature to: Cecil Baird 4700 N US Hwy 33 Remember to include pictures with your entry. Ligonier, IN 46767 For questions, email Cecil at jjbaird@ligtel.com
Information about the Record Fish
Date Caught Lure or Bait Used
For Kept Fish: Weight in lbs and oz. (or decimal ) Length Girth For Released Fish: Length in inches
Name of Business with Certified Scale
Address of Business include street, city, and state
Phone Number of Business include area code
Location of Pond include city, county and state
Pond Owner Signature of Pond Owner________________
Information about the Angler
Name of Angler Please Print or Type
Street Address
City StateZIP
Phone Number include area code
Email Address Please verify your email address. This is how we will contact you.
Signature:_____________________________ Date: ____________
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