Membership Request - Quilchena Golf & Country Club

* required

Personal Information:

*First Name:

*Last Name:

*Gender:

*Email Type: Personal Business

*Email:

Address Information:

*Address Type: Business Address Seasonal Residence Home Address

*Street 1:

Street 2:

*City:

*State/Province:

*Zip/Postal Code:

*Country:

Phone Number Information:

*Phone Number Type(s): Primary Business Number Cellular Number Residential Number

*Area Code: *Phone Number: Extension:

*Country (Phone):

Golfer Information:

*Age Category:

*How long have you been playing golf?

*How many golf rounds do you play annually?

*Where do you play most of your golf?

What is your current handicap?

If you don't have a handicap, what is your average score per game?

*Who in your family plays golf?

Self Spouse Children

Were you referred by a club member? If yes, please provide name:

Have you visited Quilchena before? If yes, for what reason:

Golf Guest Golf Tournament
Wedding Reception Social Event or Meeting

Comments: