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| Please complete this form and return it to the Secretary. |
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WEXFORD GOLF CLUB
Application for Membership
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Title: |
_____ | |
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First Name: |
___________________ | |
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Surname: |
___________________________ | |
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Date of Birth: |
__________________ | |
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Address: |
______________________________________________ ______________________________________________ ______________________________________________ |
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E-mail Address: |
______________________________________________ | |
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Phone Number: |
_______________________ | |
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Mobile Number: |
_______________________ | |
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Fax Number: |
_______________________ | |
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Proposed by: |
______________________________________________ | |
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Seconded by: |
______________________________________________ | |
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Type of Membership: (Please Tick) |
c Full c Junior/Juvenile c Pavillion c Student |
You may include any additional information with this form in support of your application. |
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