Author: Emma Carroll

GOLF MEMBERSHIP FORM

GIVEN NAME ___________________________ SURNAME ______________________________
ADDRESS ______________________________________________________________________
SUBURB _______________________________ STATE & POSTCODE _______________________
TELEPHONE (H) _________________________ TELEPHONE (W) __________________________
MOBILE _______________________________ DATE OF BIRTH ___________________________
EMAIL ________________________________________________________________________

Social Membership Golf Membership
$5.00 1 Year Social $575.00 12 Months Full Golf Member
$12.00 3 Year Social $335.00 9 Hole Golf Member
$18.00 5 Year Social $310.00 Country Golf Member
$245.00 Youth Golf Member (19—21 years)
$80.00 Junior Golf Member (up to 18 years)
You must be a Social Member to become a Golfing Member

Would you like to make the Bega Country Club your Home Club? YES NO
Please state your previous Home Club ______________________________________________
Handicap _______________________ GLN __________________________________________
Signature _____________________________ Date ____________________________________

OFFICE USE ONLY SECTION
MEMBERSHIP NUMBER ………………………………………………
DATE PAYMENT MADE………………………………………………..
STAFF PROCESSING MEMBERSHIP …………………………….