New Member Form

Yearly Membership Dues are  $60

    Print then Mail Form with Check to:

Northwest Georgia Sr. Golfers Assoc.
20 Timberwalk Court
Cartersville, GA  30121

Make check payable to:  Northwest Georgia Sr. Golfers Assoc.

Name:      __________________________________________________________

Address:    __________________________________________________________

City: _________________________________ State: ____ Zip:  ____________

Phone:  _________________________ Date of Birth: ____________________

Handicap (index): ________ GHIN #: ___________________

Home Club:  ________________________________________________________

Email Address:  ____________________________________________________

Sponsor #1:  _______________________________________________________

Sponsor #2:  _______________________________________________________

Sponsor #3:  _______________________________________________________

Signature:  ______________________________________ Date: _____________