SAN MATEO COUNTY GOLF CLUB Associate member of the Northern California Golf Association 2010 MEMBERSHIP APPLICATION (Membership term is from 12-2009 through 11-2010) NAME____________________________________ Home Phone _____________ ADDRESS_________________________________ Work Phone _____________ CITY__________________________________________ZIP________________ Email address________________________________ PONY_______________ Birth Date _________________________________ Check here if there are any changes to your current information __ Flights: Members in handicap will play in flights based upon their NCGA handicaps. Please indicate which flight you wish to play in and remember that you must remain in your chosen flight for the entire year. All flights use 100% of course handicap. Play in the Championship Flight optional tees (money/green fees credit prizes)____ Play in the Handicap Flight from white tees men/red women (ball prizes)____ DEADLINE FOR PAYMENT IS DECEMBER 6, 2009 IMPORTANT: A NCGA reinstatement fee of $10.00 must be paid by non-junior members who submit their dues and application after the deadline. Also a $5.00 late fee will be imposed by SMCGC Membership Type SMCGC Dues NCGA Fees Total Your Total Regular $40.00 $30.00 $70.00 _________ Associate $43.00 $30.00 $73.00 _________ Junior (under 18) $10.00 $ 6.00 $16.00 _________ New NCGA Member (junior exempt) $10.00 $10.00 _________ Initiation Fee/Reinstatement Please make your check payable to SMCGC - Total due __________ There is no initiation fee charged if you are transferring your NCGA membership to SMCGC from another golf club. If you are a new SMCGC member and are transferring your NCGA membership from another club, please complete the following: Your NCGA Membership number __________________________________ Your NCGA Golf Club ___________________________________________ Associate members are non-County employees who are sponsored by a San Mateo County Employee who is a member in good standing with SMCGC. After one year of Associate Membership, Associate Members become regular members. If you are applying for Associate Membership, please fill out the below listed information. Name of Regular Member who is sponsoring you_______________________ SEND THIS APPLICATION TO: Dick Flanagan 706 Santa Cruz Lane Foster City, CA 94404-3792