Bella Vista 9 Hole Women’s Golf

2012 Membership Application
 

 

Last Name__________________________  First Name___________________________

                                (Please Print)

 

POA Activity Card No._________________      E-mail______________________________

                           (Include Leading Zeros)

 

Address_______________________________ City_________________ Zip__________

 

 

Telephone____________________  Alternate Phone_____________________________

 

First Time Member:  Yes ______   No _______ If yes, please include five 9-hole score cards
(18-hole score cards may be used as two 9-hole scores) from any course except Branchwood and Brittany.

 

Able to provide a cart whenever asked.  Yes______    No ______ If yes do you have Private Cart ?_____ Lease Cart ?_____

 

 Membership  ($25.00) $__________

Handicap Fee ($5.00) $__________

Hole In One - Optional ($2.00) $__________

Total Paid $__________

Date Paid ____________

  

 If you are paying handicap fee through another source please
check  which one:

 18 Hole Women's Golf ____

 Golf Admin Office ____

 

 

Make checks payable to: BV 9-Hole Women’s Golf Club

Mail this form with check to:
Judy Lemoine
9 Hole Women's Golf
32 Chelmsworth Drive
Bella Vista, AR 72715

IMPORTANT:  To assure your name & phone are listed in our 2012 Roster, please submit dues on or before March 21, 2012.

Questions?  Please call (479) 366-5554

 

By joining this league, I agree to abide by its rules. (Rule books are available upon request.)

 

Signature: ____________________________________________ Date:_____________

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