PHGA CODE: __ __ __
Name:
Address:
City:
State:
Phone:
Email:

__ Do-Not publish my email address on the website roster.

__ Do-Not include my email address for broadcast email*.

Payment:
After April 24th – $50.00

Membership Form and Payment can also be placed in the BLACK BOX in the Clubhouse.

NEW MEMBERS: Please fill out the form and submit with your payment. We will give you a PHGA code number and add your email address to the PHGA roster.

Mail this application with a check payable to PHGA to:

Joe Saccomanno
45 E. Gilbert
Palatine, IL 60067

* By checking this I understand that I will not receive email announcements from the PHGA Board on tee time information, special event information or requests from other members looking for substitutes. We use Yahoo Groups to make our club announcements: phgagolf@yahoogroups.com