I wish to apply for membership of the Motueka Golf Club Inc.

Name (Mr/Mrs/Miss)……………………………………… …………………………………………
Please print in block letters (First name) (Surname)

Address: ………………………………………………………………………………………………………

………………………………………………………………………………………………………………………

Home Phone: ………………………………….. Business: ……………………………………..

Email…………………………………………………………………………………………………………....

Age Bracket: (10/20) (20/30) (30/45) (45/65) (65 plus)

Occupation:……………………………… Past (if retired)………………………………………

If transferring from another club, name of Club…………………………………………….