|
|
|
Player |
Name |
First Name
Last Name
|
| Address |
|
| City State Zip |
A value is required.
|
| Phone |
Home |
|
| Cell |
|
| Email |
|
| Citizenship |
A value is required. |
| University |
If you desire to represent your university, please list the name of that university. |
| Name |
|
| City, State |
|
| Applicant
must have an up-to-date USGA Handicap Index not exceeding 10.4
under the USGA or R & A Handicap system. Handicap Indexes
will be verified using the information supplied
on this entry form. Please be accurate with the name of the club,
association or company used to calculate your handicap index, your member name and
the member number assigned to you by this club, association or
company. |
| Handicap |
USGA Licensed
Club |
Club Name |
|
| City, State |
|
| Ghin Number |
|
OR
Licensed
Handicap
Company |
Company Name |
|
| Web Address
|
|
| LHC Phone |
|
| Member Name |
|
| Member Number |
|
| Caddies |
A contestant requesting a caddie will be obliged to hire the caddie
for a minimum of two rounds. Caddie fee is $50.00 per round, plus gratuity. |
| Please click
on one of the following:
|
|
I request a club caddie*
Beginning on
(mm/dd) |
|
I will carry my clubs |
|
I will bring a caddie |
|
|
| Special Events |
I
am eligible to compete for a special award during Qualifying (click
to check): |
|
Junior Medalist - Born after July 28, 1994 - Date of Birth:
(mm/dd/year) |
|
Senior Medalist - Born before July 24, 1962 |
|
Team Trophy - Lowest qualifying scores (two days)
of two contestants who represent the same club or University |
| Housing |
Only junior contestants, unaccompanied by an adult, may request housing. |
|
I am an unaccompanied-by-an-adult junior contestant requesting housing. |
|
|
| DATE:
(mm/dd/year) |