P.O. 3403, MOKA, MARAVAL, TRINIDAD, WEST INDIES, PHONE: (868) 629-0066, 2314, FAX: (868) 629-0411

Junior Membership Application Form
NB: Completed application forms must be accompanied by the applicable fee for Junior Applicants.
Minimum age required is 7.

NAME OF APPLICANT__________________________AGE:_________ DATE OF BIRTH____/____/____

LOCAL ADDRESS_____________________________________________________________________________
______________________________________________________________

PHONE (H)_______________________ PHONE (C)___________________________________________

E-MAIL ADDRESS_____________________________________________________________

PREVIOUS CLUBS (IF ANY) _______________________________________HANDICAP ____________

PARENT/GUARDIAN _________________________________________ PHONE (O) _______________

OCCUPATION___________________________ EMPLOYER____________________________________

BUSINESS ADDRESS___________________________________________________________________

IN CASE OF EMERGENCY CONTACT______________________________ PHONE_______________

DOCTOR’S NAME______________________________________________ PHONE_______________

EXHISTING MEDICAL CONDITION(S)? ____________________________________________________

SIGNATURE OF PARENT/GUARDIAN ______________________________DATE__________________

 I, THE UNDERSIGNED PROPOSER, BEING A MEMBER OF ST. ANDREW’S GOLF CLUB AND PERSONALLY
ACQUAINTED WITH THE APPLICANT FOR ______________________ (MONTHS / YEARS),
TAKE PLEASURE IN PROPOSING THIS APPLICATION.

THE SECONDER OF THIS APPLICATION MUST BE A MEMBER OF THE BOARD OF MANAGEMENT

SECONDER (Please print)____________________________         ______________________________
                                                                                                                                          SIGNATURE