Application for obtaining Handicaps

Mail to:                             OR                                               Make Check Out to:

CC of Halifax            Give to ProShop                                       CC of Halifax Men's Comm.
PO Box 196
Halifax, Ma 02338

 

  *Required   

Type of Membership*:         

Name* :  First  Last Suffix     

Address*:

Town*:     Zip Code*:

E-Mail:     GHIN* #:

Home Phone*:   Cell Phone:

DOB(for junior membership only):

  Optional Hole in One     (See Mailing)

   FAMILY INFO    

     Additional Members (If junior member-17 and younger- enter birthdate, yy-mo-day)

             Name:   Date:   GHIN #:
                  Optional Hole in One  

             Name:   Date:   GHIN #:  
                  Optional Hole in One  

             Name:   Date:   GHIN #:  
                  Optional Hole in One  

             Name:   Date:   GHIN #:
                  Optional Hole in One  

   BUSINESS INFO

               Name of Business Account: 
              
           Add'l Names on the Business Account 

              Name:   E-Mail    GHIN #:
                 Optional Hole in One  

             Name:   E-Mail    GHIN #:
                 Optional Hole in One  

             Name:   E-Mail    GHIN #:
                 Optional Hole in One  

             Name:   E-Mail    GHIN #:  
                 Optional Hole in One