2009 MEMBERSHIP APPLICATION


WWPLGA CLUB MEMBER--$35.00


*WWPLGA INDIVIDUAL MEMBER (SINGLE PERSON)--$15.00


Make check payable to WWPLGA:  Please remit to:

                                                         Geri Lee-Petersen

                                                           4829 Charles Street

                                                        Racine, WI 53402


CLUB/INDIVIDUAL INFORMATION:


NAME________________________________________________________________

ADDRESS_____________________________________________________________

CITY___________________________________STATE_________ZIP_____________

PHONE_______________________________________________________________

E-MAIL ADDRESS______________________________________________________

CLUB AFFILIATION_____________________________________________________




CLUB/REPRESENTATIVE:


NAME________________________________________________________________

ADDRESS_____________________________________________________________

CITY___________________________________STATE_________ZIP_____________

PHONE_______________________________________________________________

E-MAIL ADDRESS______________________________________________________



                                                                                                  TOTAL:______________




PAYABLEMay 15, 2009


*Individual golfers who want to play in tournaments but do not belong to a WWPLGA club.

Club and Individual

Membership Application

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