Title: Mr/Mrs/Ms:

Surname

Christian Name(s):

Address

Date of Birth

Mobile Phone

Your email

Occupation

Employer / School/ College:

In the case of an emergency, please notify:

Name:
Phone
Relationship

Select a membership type FullSeniorSuper SeniorSuper Super SeniorBeginnerIntroductoryCountryOverseasAssociateSenior AssociateSummerYoung AdultJuniorPavillionStaffLife MemberOfficers

Present Golf Club and G.U.I Card No. (if applicable):

Present Handicap (if applicable):

Do you wish Mullingar to be your home club for handicap purposes?
YesNo

If you are not now a member of a club but were in the past, please give details:

Name of most recent Club:

Your handicap on leaving the club:

Are you a member of a golf society?YesNo

If YES, please give name of society:

Secretary’s Name, Address and Phone Number:


Society Handicap:

For successful applicants wishing to acquire a handicap, 3 completed score cards must be signed by a member and returned to the Handicap Secretary.
I hereby apply for membership of Mullingar Golf Club. I consent to attend an Interview Board if requested. Should my application for membership be
successful, I undertake to make myself acquainted with and abide by the Constitution and Rules and the Bye Laws of Mullingar Golf Club and the Rules
and Etiquette of the game of Golf.

Signature of Applicant: