Applicants Full Name _______________________________

Date __________

Address

________________________________________________________

________________________________________________________

________________________________________________________

Post Code _______________

Tel. No _________________

Mobile __________________

E-Mail ________________________________

Occupation ______________

Date of Birth _______________

How long have you lived at the above address ________Years

Previous Club (If any) ________________________________

Present Club (If any) _________________________________

Are you a Golfing Beginner YES / NO

Handicap (if any) __________________

Signature ___________________________________________

Club Referee _________________________________________
(Please Print Name in Capitals)

The Club prefers a referee to be a voting member of Pontypool Golf Club, to whom you must be personally known.
If a member of the Club is not known to the candidate for any reason then another suitable referee will be needed.

Other Referee

Name

___________________________________

Address

________________________________________________________

________________________________________________________

________________________________________________________

Post Code _______________

Tel. No. _________________

I desire to become a Playing / Non Playing / Country / 19 - 25 Year Old Member of Pontypool Golf Club and agree at all times to be bound by it's Rules and Regulations