ANNUAL MEMBERSHIP DUES 2011……$60.00

(This includes $15.00 to the Priscilla Maxwell Endicott Scholarship Fund)

Additional contributions to the Scholarship Fund will be gratefully received and acknowledged for tax purposes.

 

DUES MUST BE PAID BY MARCH 1, 2011

 

MEMBERSHIP WILL LAPSE IF DUES ARE NOT PAID BY MARCH 1, 2011.

 

 

Name__________________________________________________________

 

 

Tel. No. w/area code___________________________________________________________

 

 

*CT Address________________________________________________________

 

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Email address_________________________________________________________

 

**Birth Date:  Month____________________ Day________________ Year_______________________

 

Club________________________________________________________________

 

GHIN Number_______________________________________ Index Number_____________________

 

* 1.  List winter mailing address with dates on back to receive booklet there.

  2.  If birth date is not given you will be ineligible for Senior Tournaments.

  3.  If not renewing, please let us know.

 

MAKE CHECK OR MONEY ORDER PAYABLE TO:

CWGA

And mail with this bill to:

 

CWGA

c/o Mim Schreck

101 Spring Hill Road

Fairfield, CT  06824