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Tashua Knolls Mens Club


 2018 MEMBERSHIP APPLICATION

Please print information clearly.
Do not use first name initials or nicknames.
Include Jr, Sr, or other designations where applicable.
Mail application and check to:
TKGC Membership, 93 Skyview Drive, Trumbull, CT 06611
(make check payable to TASHUA KNOLLS GOLF CLUB)

PLEASE DO NOT STAPLE CHECKS TO APPLICATION


  NAME
: FIRST_______________________M.I._______LAST_________________________

  ADDRESS: STREET_________________________________________________________

                        TOWN_____________________________   STATE_______   ZIP___________

  TELEPHONE NUMBER (list one or both):

        (
_______)____________________(Home)            DATE OF BIRTH: _______________

        (_______)____________________(Cell)

  EMAIL ADDRESS: _____________________________________________
     (Never sold or distributed)

  STATUS (CHECK ONLY ONE):                          FEE* (CHECK ONLY ONE):

    (   )  RENEWAL - WAS A MEMBER LAST YEAR      (   )  $90.00 - REGULAR MEMBERSHIP

    (   )  NEW - WAS NOT A MEMBER LAST YEAR       (   )  $20.00 - JUNIOR MEMBERSHIP**

   * MEMBERSHIP INCLUDES UNITED STATES GOLF ASSOCIATION HANDICAP       
  
**LESS THAN 18 YEARS OLD AT DATE OF APPLICATION

Please provide the following information if you have a GHIN number so we can carry your handicap information forward to Tashua.  For questions call 203-378-2771Leave your name, phone number, and any message if we are not available when you call.  We will return your call.

  CLUB NAME_______________________________GHIN NUMBER:_____________     

DO NOT WRITE BELOW

  RECD_______________    $________________   REG__________    #___________________






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