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Download
Membership Form: PDF
Version Word
Version
Remit Forms & Fees to:
New
England Pro Golf Tour, PO Box 1093, Littleton, MA 01460
Toll Free/ 866-232-6378
Direct/
978-486-0396 Fax/ 978-486-3380 Overnight
mail address: New
England Pro Golf Tour, 498 Newtown Rd, Littleton, MA
01460 To
reserve your spot for the 2006 New England Pro Golf Tour send
this form with a $500. deposit.
Membership
(check One): Full
Spot ___ ($12,050
total due now)
Half Spot___ ($6,650 total due now) Method of Payment: Check #
Cash
MC/Visa,
Only*
Amount Enclosed
PLAYER
INFORMATION PLAYER’S NAME:
SS # OR TAX ID #:
Mailing
Address:
CITY
STATE______
ZIP (This
address is where you want information sent) Additional
Address:
CITY
STATE______
ZIP (If
prize money checks need to be sent to alternative addresses;
such as to sponsors or banks) HOME PHONE # _______________________________
CELL PHONE#_________________________________
STATE EMAIL
ADDRESS
MC/VISA
Only#
exp
CARDHOLDER’S
NAME
CARDHOLDER’S
SIGNATURE
PLAYER PROFILE – Please fill out completely as it will be
posted on the New England Pro Golf Tour Website
HEIGHT:
WEIGHT:
DATE OF
BIRTH
AGE: __________ BIRTHPLACE:
CITIZENSHIP:
Hometown
(where you want to be listed from):
MARRIED
/ SINGLE (circle one)
WIFE'S NAME:
CHILDREN:
HOMETOWN
NEWSPAPER: ____________________________ COLLEGE:
MAJOR:
GOLF
CLUB AFFILIATION (current or past):
YEAR
TURNED PRO:
COACH/PRO:___________ OTHER
INTERESTS:
CAREER
HIGHLIGHTS:
LOW
ROUND PROFESSIONAL: ___________
when and where:
HAVE
YOU PARTICIPATED IN PGA QUALIFYING SCHOOL? __________ IF YES, WHEN: _________
______
EMERGENCY
CONTACT:
PHONE
#:
The
balance of $11,550 (full time players) is due now to
secure your position. The balance of $6,150 (half spot
players) is due now to secure your position. The penalty
for withdrawal after March 15, 2006 is $1,000 plus the $500
deposit ($1,500). The penalty for withdrawal after May 15 is
$2,000 plus the $500 deposit ($2,500). By
signing below you are agreeing to the payment schedule and media
policy explained. Signature:____________________________________________________________Date:___________________ Membership application
will not be accepted without signed Media Form, Player Agreement, and payment. You will receive
a membership confirmation within seven business days of
receiving your registration.
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