Contact Information

First Name:   *

Last Name:     *

Address:     *

City:     *

State:      Zip:     *

Method of Contact    

* Include Home/Cell Info for Quicker Processing & Fishing Questions *

Home Phone:                *

Work Phone:             

Cell Phone:                   *

Local (Florida) Phone:

Email:    *

Contact Instructions:   *

Dates

Arrival Date:     *

Departure Date:   *

Dates Available to Fish:   *

Preferred Dates to Fish:   *

Party

Number of Anglers in Party:    *  Ages:  

Relationship:  

Occasion:   Birthday     Anniversary     Vacation  

                     Annual Fishing Get-a-Way     Business Trip

                     Other - Please specify in detail, especially a surprise gift! 

Average Experience Level of Party:  

                                 Highly Experienced Experienced Fair Just Learning None at All

Charter Information

Charter Location: *

                   PANHANDLE * Destin / Fort Walton Beach * Pensacola NORTHWEST * Crystal River, Homosassa * Cedar Key WEST CENTRAL * St. Petersburg, Treasure Island, Tampa * Sarasota, Bradenton, Venice, Anna Maria * Tarpon Springs, Palm Harbor, Clearwater, Dunedin SOUTHWEST * Boca Grande, Charlotte Harbor, Punta Gorda * Englewood / Venice * Pine Island, Sanibel, Captiva, Ft. Myers * Ft. Myers / Estero NAPLES/MARCO/10K * Naples, Chokoloskee, Everglades City SOUTH to THE KEYS * Ft. Lauderdale, Miami, Biscayne Bay * Flamingo - Everglades Nat'l Park, Key Largo * Islamorada, Tavernier, Key Largo * Big Pine Key to Keywest EAST CENTRAL * Daytona Beach * Orlando * Mosquito Lagoon, Indian River, Titusville, Cocoa Beach NORTHEAST * Jacksonville North, Amelia Island, Fernandina Beach * Jacksonville South, St. Augustine, Ft. Matanzas

Where will you be staying?  

If a waterfront Hotel/Motel/Resort/Home, would you prefer an "On the Water" Pick up and drop off?

                                               Yes No Does not matter

* Captain & or area you wish to fish with: *                                 

                  Derrick Jacobsen (SW FLA and West Central) Carl Smith (SW Fla) Ariel Cabrara (Naples, South) Ron Schurr (Northeast) Tony Bozella (North East) Bryan Pahmeier (East Central/Orlando) Mike Witfoth (West Central) Dan Cambern (SW Fla) Dan Haley (Naples/Marco/10k) Dave Pomerleau (West Central & SW FLA) Eric Herstedt (South Fla to the Keys) Greg DeVault (West Central) Ryan Rowan (SW FLA) J.W. Romish (NW Fla) Jimmy Willis (SW Fla) Jarret Lombard (SW Fla) Jimmy Hobales (South Fla to The Keys) Jim Ross (East Central and Orlando) Joe Lowery (Panhandle) John Turner (West Central) Mike Weinhofer (Key West) Keith Benson (West Central) Phil Haley (Naples, Marco & 10k) Ray Culver (Naples, Marco & 10k) Ray McCauley (Northeast) Robert Moore (SW Fla) Scott Whitehurst (Panhandle) Tony Tradd (South FLA to the Keys)

Charter Length: * 

                        Full Day (8hrs) Three Quarter Day (6hrs) Half Day (4hrs) 8-hr Split Day (4hr Morning + 4hr Evening) 4-hr. Evening Trip 6-hr. Evening Trip 6-hr Offshore 8-hr Offshore 10-Hr Offshore 12-hr Offshore 15-hr Night Offshore (Snapper)

Species You Wish To Target:

(Please hold down the Ctrl button and use your mouse to select all that apply)

                                               Bonefish Cobia Dolphin (Maui Maui) Drum Goliath Grouper (Jewfish) Grouper Jack Crevalle Kingfish Little Tunny Mackerel Permit Pompano Redfish Sailfish Shark Snapper Snook Sea Trout Tarpon

Preferred Method of Fishing (Please hold down your Ctrl button and use your mouse to select all that apply):

                       Spinning Bait/Plug Casting Fly-Fishing Live Bait Only Artifical Lure Only Sight Casting Only Does not matter...just want to catch fish                            

Please tell us about yourself and your party, so we may design a charter trip

that best suits the needs of you and your guest:

Other

Have you ever fished with a Florida Light Tackle Charter Guide;

                                                      Yes No                                                     

If so, who was your captain?  

Do you wish to fish with him; or would you prefer another captain?                                                  

                           Yes No Does not Matter

Have you ever fished in Florida? 

                                                   Yes No   If so, when?  

Where did you fish?  

What did you catch?  

Did you fish privately or did you hire a guide?  

                                                                         Privately with a Guide

How would you rate your experience?  

What can Florida Light Tackle Charters.com do for you and your guest to provide a most exciting, yet relaxing time during your fishing trip with us?

So we can properly extend a "Thank you", how did you hear about us?

Please view our FAQS page for more info:

You may provide us your credit card information in the boxes below; or email us with your credit card number, card type and expiration date; or you may call us  @ 941-628-1355; or you may print this form, include payment and mail to:    

Florida Light Tackle Charters

17044 Greenan Ave.

Port Charlotte, FL 33948

Do you wish to remit your deposit to lock in your charter now or later? 

                                                      Now Later   *

To Remit your deposit now, please provide us with the following information:

Card Type:  

                              Master Card Visa American Express Discover *

Card Number:     *   

Exp Date (mm/yr):   *

Card Code: (3 or 4 digit)   *

* Complete billing address must accompany Credit Card if other than home address above *

 Billing Address>    *

Thank you for reserving a light tackle charter with Florida Light Tackle Charters.com.  Once we process your deposit, Florida Light Tackle Charters will email you a trip confirmation within 24 hours.   

Please Read our "Liability" disclaimer & "Deposit Policy" below, before clicking on the submit button.