Membership Application Form
FULL MALE - £275:
FULL FEMALE - £275:
SENIOR over 65 - £219:
COUNTRY (over 30 miles) - £190:
STUDENT INTERMEDIATE 18 to 21 - £160:
JUNIOR (under 18) - £99:
JUNIOR (under 16) - £65:
Surname:
Forename:
Address:
Post Code:
Tel Number Home:
Mobile:
Email Address:
Member of another club:
No
Yes
Handicap:
Occupation:
Signed:
Date:
Please print and return to:
MOSS VALLEY GOLF CLUB
MOSS ROAD
WREXHAM.
LL11 4UR.
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