Membership Form

Please complete the information below.

Indicate your membership level.  All dues include your NCGA membership.  (NCGA dues are required each time you join a new club.  Refunds from NCGA are available, please apply at www.ncga.org).

New Member...$105
Renewing Member...$105

Please provide the following contact information:

First Name
Last Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone
Home Phone
FAX
Cell Phone
E-mail
ParTee Member Referral:

Do you have a GHIN No?

Yes  No

If yes, please provide us with your number

What is your play level?

Beginner - just started learning how to play
Novice - higher level handicap
Intermediate - mid level handicap
Semi-Pro - low level handicap

What is your handicap?

___________________

Monday     Tuesday    Wednesday  Thursday 
Friday     Saturday   Sunday     

What type of clinics would you like to participate in?

Please print out and sign your name in the space below, and mail in with your check.

____________________________________
(print name):  ________________________