First Name:

Surname:

Address:

Address 1:

Town:

Postal Code:

Telephone:

Email:

Have you ever previously been a member of a golf club?
Please Choose Yes Never

If yes please state name and address of your last club:

Have you ever been refused membership of a club or had you membership cancelled?
Please Choose Yes Never

If yes please give deatils:

I wish to apply to join Prestatyn Golf Club as a

Please Choose Gentleman residing up to 30 miles Gentleman over 65 residing up to 30 miles Gentleman residing over 30 miles Juniors under 12 on January 1st Juniors under 16 on January 1st Juniors under 18 on January 1st Lady residing up to 30 miles Lady over 65 residing up to 30 miles Lady over 70 ( Member for 10 years ) Lady residing over 30 miles Joint member Social member Overseas member Winter membership ( Oct - Mar )


please type the letters and number as shown