NORTHERN NEW MEXICO SENIOR MEN’S GOLF ASSOCIATION

6533 Winding Ridge Loop

Santa Fe, NM 87507-3191

Voice: 505-412-5854

Visit us at www.nnm-golf.org

2010 APPLICATION FOR NEW MEMBERS

DUES $40.00

NAME_______________________________________________ LADY’S NAME__________________

(last) (first)

SUMMER OR YEAR ROUND ADDRESS___________________________________________________

CITY____________________________________ STATE_______________ ZIP____________________

HANDICAP __________ GHIN NUMBER __________CLUB AFFILIATION____________________

PHONE (Home)____________________(Cell)_______________________(Office)_______________

E-MAIL ADDRESS__________________________________________DATE of BIRTH_____________

I PREFER TO RECEIVE ENTRY FORMS BY EMAIL________ or US POSTAL SVCE_________

NEITHER, I’LL GET MY ENTRY FORMS FROM THE WEB SITE_________

IF YOU HAVE A WINTER ADDRESS

ADDRESS_____________________________ CITY_________________ STATE______ ZIP_________

PHONE # ___________________ WINTER DATES FROM ________________ TO ________________

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PLEASE MAKE YOUR CHECK PAYABLE TO NNMSMGA AND MAIL TO

6533 Winding Ridge Loop

Santa Fe, NM 87507-3191

TO BE INCLUDED IN THE MEMBERSHIP DIRECTORY, YOUR CHECK MUST BE RECEIVED BY FEBRUARY 15, 2010

Revised 11-29-09