PLEASE BE SURE TO READ BEFORE SIGNING

Membership Application

You are cordially invited to join the SHORELINE SENIORS GOLF CLUB, a group of golf enthusiasts who will reach or exceeded their 55th birthday during the coming year.

In applying for membership, you agree to; (1) Comply with the By-Laws, Rules and Proce-dures of this club; (2) Honor 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. If application is from a person residing outside Mountain View, it may be subject to delay in acceptance if the membership is filled. There is no quota for residents of Mountain View if otherwise qualified.

DUES and FEES

SHORELINE SENIORS N.C.G.A

DUES INITIATION DUES INITIATION TOTAL

$40.00 $25.00 $25.00 $10.00 $100.00

The total amount is to be paid BY CHECK with the application. Make all checks payable to: SHORELINE SENIORS GOLF CLUB. Mail check with the lower portion of this application to:-

Bruce Fujikawa .

21572 Columbus Ave.

Cupertino, CA .....

The golfing year is from January 1st to December 31st. There are no prorated dues for applicants joining from January 1st to September 15th. Any applicants after September 15th will be paying dues for the next year and will be able to participate the remainder of the current year without further dues and only payment of the course fees. Guarantee.....If you join after September 15th and find that our club is not what you want, a letter to our membership committee dated prior to December 1st will bring a full refund. No other refunds are allowed.

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For Club Records, please print the following information:

NAME__________________________________HOME PHONE #________________

as it will appear on N.C.G.A. Roster

STREET______________________________________BIRTH DATE______________

CITY______________________STATE___________ZIP CODE__________________

CURRENT GHIN #___________________CURRENT INDEX_______________________

E-MAIL____________________________WEB SITE__________________________

rev 08/03

. May your e-mail address be published in the Membership Directory and/or Shoreline Seniors website? Check one:-----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)

I certify that the above information is correct:

SIGNED_______________________________________DATE_______________________