Para Golf Club
Bay Area Northern California
Membership Application

I herby apply for membership in the Para Golf Club Bay Area Northern California. Upon acceptance of membership, I agree to abide by the rules and by-laws of the Para Golf Club. I agree further, to accept the decisions of the members of the Para Golf Club as they apply to the rules and by-laws of said club and as they apply to me.

Name ____________________ Spouse's Name ____________________

Address ____________________ Birth Date ____________________

  ____________________

City: ____________________

State: ______

Zip: ___________

Phone: ____________________ (home)

  ____________________ (work)

Email: ____________________

Fill out the following if applicable:

My present NCGA Index is ______ GHIN Number: _________________________

This card if from (Name of Club) _________________________________________

I am resigning from that club: Yes ______ No _______

If No, write the name of the club you wish to be your Home Club ____________________________

All applications are subject to review and approval by the Para Golf Club, Bay Area, Northern California members

Regular Membership - Initiation Fee (a one-time fee) - $25.00

New Member - Annual dues $65.00 The fiscal year is January to December.

Note: To play in any monthly Club Tournament or Club Annual Champion Tournament, a new member must have a current NCGA index, USGA sanctioned or membership course also is acceptable. To play in any other club tournaments, submitting to the Handicapped Chairman, 5 or more recent attested scores from a NCGA, USGA Member Course may establish a temporary handicapped.

If you are approved for membership, you will be notified by mail by our club membership chairman, if disapproved, your check will be returned to you.

Initiation fee and first year's dues must accompany application.

Mail to: Tom Pangelinan - Treasurer
107 Larkwood Circle
Danville, CA 94526

Applicant's Signature: ___________________________ Date: _____________