Arroyo Golf Club Membership Application

PERSONAL Information: Date: ___________

New Member: ___ Membership Renewal: ___

______________ ________________

First Name Last Name

______________ ____________ _____

Address City/State Zip Code

______________ ___________ ____________

Home Phone # Work Phone # Cell Phone #

__________________ ___________________

Email Address Birth Date (mm/dd/yyyy)

________ ____________ ________________

Handicap Referred By: Prior golf club affiliation

Which of the following committees would you like to join? (Select one or more)

Tournament: _______ Handicap: _______ Membership: ______

Elections: ________ Public Relations: _________

Annual New Member Dues: $85.00 Renewal Membership Dues: $80.00

Associate Membership: $30.00 After June 30 New Member Dues: $50.00

Send Check To: Arroyo Golf Club

P.O. Box 6446

Altadena, Ca 91003