2011 MEMBERSHIP APPLICATION

_____Applicant for Full Membership ($75)          

_____Handicap Only ($35)

_____Junior Handicap Service (no charge) Date of Birth _________(must be < 18)

                                                                                                  (MO/DAY/YR)

Name____________________________________________________

Address___________________________________________________

Town________________________________ State_______Zip_______

Best Phone #____________________________

Email_________________________________

_____Check here if this is a new mailing address

    
_____Check here if this is a new telephone number

_____Check here if this is a new e-mail address

Membership Status (check one)

__________Current Member Renewing           

__________New Applicant 

If NEW, do you have a GHIN # from another club? __NO__YES, GHIN#______ 

Remit Check to: 

RGC, PO Box 24, Ridgefield, CT 06877