SUNNYVALE SENIOR SITIZENS GOLF CLUB RENEWAL AND NEW MEMBER FORM FOR 2010

SSSGC MEMBERS PAY $75.00 UNTIL OCTOBER-31, 2009 STARTING NOVEMBER 1 st THE COST WILL BE $80.00

THE NCGA HAS RAISED THIER FEES $6.00 FOR 2010. THE CLUB WILL ABSORB THE ADDITIONAL FEES UP TO OCTOBER 31st 2009.

DATE:__________

NAME:______________________________________________
(First MI Last)

E-Mail Address:_________________________________________

Street Address:_________________________________________

City:_____________________ State:_____ Zip Code:_____________

Home Phone:________________ Cell Phone:_________________

Date of Birth:________________ Spouse’s Name:________________

NCGA GHIN:__________

Send check made out to SSSGC

Tom McKay

2 Surrey Lane

Atherton, CA 94027