APPLICATION FOR MEMBERSHIP

 ACTRVGA PO Box 928, Gungahlin ACT 2912

 

Name:    ……………………………………….………………….….…

 

Address:          ……………………………………….……………………..…

 

………………………………………………………………………….

 

…………………………………………… Post Code: ………………..

 

Email:      …………………………………………….…………………

 

Phone:      Home:    …………………….…………

 

                 Mobile:   ……………..………………..

 

Home Club: …………………………….……. Handicap: ………..….

 

Golf Link Number: …………………………

 

Date of Birth: ……………………………….

 

Membership Fee enclosed: …………………

(Nomination $10, Yearly $10)

 

Signature: …………………………………………..…….

 

Date: ………………………………………….