Three Rivers Senior Golf Association

                                        2018 Membership/Guest Application Form

 

Instructions:  The information you provide here is solely for the use of the

association and is protected.  Even though you may have provided the

information before, this information is required EVERY year for continued

membership. Please PRINT information CLEARLY for #'s 1-7 (especially e-mail

address) and sign your form at #8. Be sure to sign your application.

(1)  Last Name____________________________________ First_________________________________

 

(2)  Address_________________________________   __________________________   ______________

                              Street/PO Box                            City/Town                     Zip

 (3)  Home Course_________________________________________________________

 (4)  Phone ___________________________  E-Mail Address________________________________

 (5)  Member Since___________________  Date of Birth (Required) _______________________

 (6) Team Captain ______________________________________ 

(7)  2018 Team Playing Partners: #1________________________#2_________________________

 #3___________________________   #4__________________________ #5_________________________

(8)  " In order to be member or guest of this association, I hereby agree to abide by all association rules and the game of golf at each tournament played".

 

_____________________________________          ______________________________

                    Signature                                                Date

 For Association Use Only:

(9)   Membership Eligibility:  Approved  _________  Not Approved _________   

"AT LEAST 50 YEARS OLD, MEMBER OF THE ASSOCIATION LAST YEAR,  MEMBER OF A GOLF COURSE THAT WE PLAY NOW,  MEMBER OF A GOLF COURSE THAT WE PLAYED IN THE PAST, PAY ASSOCIATION DUES, COMPLETE ANNUAL MEMBERSHIP FORM." (Reapproved 2016)

(10)  Date 2018 Dues Paid______________________

(11)   List of tournaments this guest has played:

 1st___________Date________   2nd__________ Date__________   3rd __________ Date________

   Mail Form To:  Dick Blankenship, 122 Red Oak Lane, Searcy, AR 72143