Please print this form and fill in the required information and send it and your picture to Newaygo Online, 22 State St., Newaygo MI. 49337.
All information submitted below will be used for contact information only. It will not be sold or given away for any reason or purpose. All information will be kept confidental.

Non-published information;

Name

Please provide at least one way to contact you, either Mailing Address, Email, or Phone Number. Email is preffered.

Address:_________________________________________________
City, State, Zip:____________________________________________

Email Address:_____________________________________________

Phone Number:_____________________________________________

Published Information

All information here is completely optional. Be as specific or vague as you wish.

First Name:____________________________________________________
Last Name:____________________________________________________

Date fish or game was harvested:___________________________________

Where fish or game was harvested:__________________________________

Weapon or tools used to harvest fish or game:___________________________

Description of the fish or game:______________________________________

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