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Regular and Life memberships are open to any amputee who has anatomically lost a hand or foot
at a major joint ... wrist/elbow/shoulder/ankle/knee/hip. Associate membership is available to anyone who desires to support the National Amputee Golf Association. To join the National Amputee Golf Association, simply print this form directly from your web browser. |
Date: ______________ Name: First_______________________________ MI______ Last___________________________________ Spouse's Name: First_______________________________ MI______ Last___________________________________ Address: _______________________________________________________ City, State, Zip: ________________________________________________________________
Phone Home: ( ) - Work: ( ) -
E-Mail: ___________________________________________________ Type of Amputation: ___________________________________________ Veteran? Yes _____ No _____ Date of Birth:
________________________ Annual Dues (Regular Member): $25 ______ Annual Dues (Non-Amputee, Associate Member): $35 ______
Life Membership fee structure:
Under
age 25 $800 _____ Golfers under the age of 18, and those between 18-24 attending college or trade school and maintaining a 2.0 GPA, pay no entry fee to enter the NAGA Tournaments. ______ Please send information about NAGA and its programs. Dues payable annually by 1 February in
United States dollars. Please fill in the appropriate areas and return this form to the NAGA.
NAGA ATTN:
Bob Wilson, Executive Director
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