DIXIE SENIOR GOLF ASSOCIATION
(478-396-4469)
APPLICATION FOR MEMBERSHIP
IF YOU WANT TO BECOME A MEMBER FILL OUT APPLICATION. YOU
WILL BE PUT ON A WAITING LIST AND BE NOTIFIED WHEN THERE IS AN OPENING.
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Today’s Date: __________________
Name: _____________________________ Phone No._____________________ or ____________
Address: ____________________________ City: _______________ State: _______ Zip: ________
E-MAIL Address: (Please Print) _______________________________________________________
Birth Date: ______________ Home Course: ______________________________ Handicap: _____
Wife’s Name: _________________________________ Does She Play Golf? _______
Sponsor 1: ______________________________Sponsor 2: _______________________________
Additional Information / Comments: ___________________________________________________
_______________________________________________________________________________
IMPORTANT INSTRUCTIONS:
All of the above information to be filled in by the applicant and must include the name of TWO
Sponsoring Members willing to have applicant as a member of their foursome.
__________________________________________________________________________________________
MAIL THIS APPLICATION TO:
Paul Hibbitts, President D.S.G.A.
210 Rustic Live Oak Trail
Bonaire, GA. 31005
A $35 MEMBERSHIP FEE WILL NEED TO BE PAID ONCE YOU BECOME A MEMBER.
Date Application Received by D.S.G.A. ______________
Date Applicant Accepted: ________________________