 |
Application for Membership
2010
Mill Quarter Men's Golf
Association
c/o: Boyce Reid 2320 Corner Rock Rd Midlothian, VA
23113 |
|
| Name |
_________________________ |
| Address |
_________________________ |
|
_________________________ |
| Zip |
___________ |
| Home Phone |
_________________________ |
| Work Phone |
_________________________ |
| DOB- |
___/___/___ |
| E-MAIL |
_______________________ |
|
|
Applying for: (check all that apply) |
|
Regular |
|
Before March 1 |
$75.00 |
_____ |
| After March 1 |
$85.00 |
_____ |
|
Senior (over 65) |
| Before March 1 |
$55.00 |
_____ |
| After March 1 |
$65..00 |
_____ |
|
| Junior (with adult member) |
|
FREE |
_____ |
| VSGA Handicap Service
Only |
|
$35.00 |
_____ |
|
| _____________________________ |
___________________________ |
|
Applicant's Signature* |
Sponsor's
Signature** |
| Current
Members: Sponsor a new member and you and
your new member take $5.00 off your Application
Fee. Applications must be returned together. |
|
Mail Application with payment to address above or leave in Pro Shop
Application Generated from web at: 9/7/2010 3:31:41 AM
*Application must be accompanied with payment
**Sponsors Signature optional except for Juniors |
