Name: ___________________ _____________________________
Handicap number (fill in one):
GHIN: __ __ __ __ __ __ __ or Golf H'cap Network: ______________
Current Handicap Index: ______ . ____ (must not exceed 22.0 for men, 28.0 for women)
Home Club: _____________________________________________
Cell phone number: (_____) _____ – ______________________
Home phone number: (_____) _____ – ______________________
E-mail address: ______________________________________________
Date of birth: ________________ _____ _______
Month Date Year
Home address: _____________________________________________________
______________________________________________________
My signature below certifies that I post scores correctly, following all acceptable rounds:
______________________________________________________
Signature
If you mail this application by March 31, the membership fee is $12.
After March 31, mail this form with a check payable to "Linda Miller" for $15 to:
Linda Miller
48 Cherry Street
Mount Holly, NJ 08060