Membership Application Form

SA Player ID No.

Membership No.

Title TitleProfDrMrMasterMrsMissMsRevDsOther

Name

Surname

Email Address

Cell No.

Telephone - Home

Telephone - Work

Employer

Occupation

Application Options Application Options Mens Ladies

Select Categories Select Categories Full Male (35-60) Full Mid Adult (33-40) Full Student (19-24) Full Young Adult (25-34) Junior (5-18) Full Pensioner Male (60+) Full Senior (60+) Players Card Full Honorary Full Life Social Social (Non-Golfer) Social Ambassador Social Pensioner Absentee Gap Year Locker (R300) Cart Path Levy (R1200 p/y) Snr (60+) Cart Path Levy (R600 p/y)

Select Categories Select Categories Full Female (35-60) Full Mid Adult (33-40) Full Student (19-24) Full Young Adult (25-34) Junior (5-18) Full Pensioner Female (60+) Players Card Full Honorary Full Life Social Social (Non-Golfer) Social Ambassador Social Pensioner Absentee Gap Year Locker (R300) Cart Path Levy (R1200 p/y) Snr (60+) Cart Path Levy (R600 p/y)

Date Of Birth (example: 1981-01-31)

Residential Address

Suburb

PostalCode

Postal Address

Postal Code

Marital Status Marital StatusMarriedDivorcedSingleWidowed

I am a? I am a?StudentScholarNot Applicable

School

Grade

Tertiary Institution

Course Studying

No. of years left to completion of studies:

Name of Previous Golf Club

Last Official Handicap

I Confirm that all information entered is valid. And, that I accept the terms and conditions of ERPM Golf Club and will abide by it's rules and regulations as stipulated on the rules and regulations page. I Confirm that all information entered is valid. And, that I accept the terms and conditions of ERPM Golf Club and will abide by it's rules and regulations as stipulated on the rules and regulations page. Accept