Membership Application Form

If you have an interest in becoming a Member of the Senior Golfers Association,

please complete this Form. If you would first like to know more than you have

learned from this website, click here to contact our Membership Director.

On submission of this Form, it will be transmitted directly to our

Membership Director. He will get back to you to answer your questions

and to assist in advancing your Application.

Required fields are identified with red asterisks. If no data has been entered in a required field,

or if data has been entered in a field in the incorrect format, the background of the field will turn red

and your submission will not proceed until the field entry has been corrected.

* First Name

* Street Address

* Municipality

* Preferred Telephone (e.g., (555) 555-5555)

Emergency Contact - First & Last Name

* Email Address

* Last Name

Unit #/Apt #

* Postal Code (e.g., A1A 2B2)

Alternative Telephone (e.g., (555) 555-5555)

Emergency Phone (e.g., (555) 555-5555)

* Date of Birth (e.g, yyyy/mm/dd)

If an Active Member referred you to the

SGA, please provide his name below:

Referred By