APPLICATION FOR MEMBERSHIP EASTERN
NEBRASKA SENIOR GOLF ASSOCIATION
P.O. Box 97, Boys Town, NE 68010-0097
ANNUAL DUES-$30.00 I hereby apply for membership
in the Eastern Nebraska Senior Golf Association…
________________________________________________________________________
Name (please print)
________________________________________________________________________
Address
________________________________________________________________________
City
State
Zip Code
________________________________________________________________________
Telephone Number and Cell Number
Date of Birth
________________________________________________________________________
Wife’s Name
________________________________________________________________________
Signature
________________________________________________________________________
E mail Address
________________________________________________________________________
Shirt Size
MAIL CHECK TO:
EASTERN NEBRASKA SENIOR GOLF ASSN.
P.O.
Box 97
Boys Town, NE 68010-0097
