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Tashua Knolls Mens Club


 2018 MEMBERSHIP APPLICATION

           
Please print all 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: _____________________________________________

MEMBERSHIP STATUS (CHECK ONLY ONE):   MEMBERSHIP 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 (U.S.G.A.) 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:_____________


YOUR SIGNATURE:____________________________________     DATE: __________________

DO NOT WRITE BELOW

RECD_________________    $__________________     REG__________    #___________________






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