MEMBERSHIP APPLICATION
Please Print:
NAME_____________________________________________________
ADDRESS__________________________________________________
CITY________________________State____ZIP____________________
HOME TELEPHONE__________________________________________
CELL PHONE_______________________________________(optional)
E-MAIL ADDRESS___________________________________(optional)
DATE OF BIRTH_____________________________________________
(month)
(day)
(year)
CURRENT/PAST MEMBER OF____________________________CLUB
MEMBER NUMBER IS/WAS ______________ INDEX WAS/IS ______
I hereby apply for membership in the Victoria Senior Men’s Golf Club, subject to the
by-laws, rules and regulations of said club SCGA and the USGA.
SIGNATURE OF APPLICANT___________________________________
This application, accompanied by a check for
$65.00, can either be mailed to:
NATE
BROWN
19402 BELSHAW AVE.
CARSON CA 90746
OR
dropped
in the Senior Men’s Club mailbox
in the VICTORIA Pro shop