SHORELINE SENIORS GOLF CLUB
RENEWAL FORM FOR FISCAL 2012
(Please read
the entire form before signing and returning)
Revised
11/25/11
Club Membership dues for Year 2012 are $76.00 ($40 Club, $36 NCGA) for Regular Member and $45.00
for Social Member. Dues are delinquent after December 16th, 2011. After December 16th, the fees go up $10.00 to
$86.00 for Regular Member and $55.00 for Social Member. Deadline for Year 2012 renewal is December 31st, 2011. Make checks payable to Shoreline Seniors Golf Club
and mail with lower portion of this application to:
Ted Roshinski, 2460 Golf Links Circle, Santa
Clara, CA 95050-7013
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here------------------------------------------------------------
Name ____________________________________
Home Phone ____________
Street
_______________________________City______________________ ZIP_________
Birth Date _____________NCGA#
______________ Home Club____________________
Email
Address___________________________________________________
May your Email Address be published in
the Membership Directory Yes_____ No ______
I would be willing to serve on Committees Yes
_____ No _____
I would be willing to serve on the Board
of Directors Yes
_____ No _____
Check one category (applying for): Regular
Member _____ Social Member _____
In applying for renewal, you agree to;
(1) comply with the By-Laws, Rules and Procedures of this Club; (2) abide by
all agreements that have been entered into by said Club and all agreements that
the Board of Directors of this Club enter into subsequent to the date of
application and (3) serve as a greeter at least once a year, as of the date of
application.
Signature_________________________________________Date_________________