Club Name:

Address:

City: State: Zip:

E-mail Address:

Telephone Number: (xxx-xxx-xxxx)

Phone #1   Phone #2

Name of Contact Person

                        Position

If you have an active Ladies Golf Association, please attach a roster of members- with email addresses

Membership Fee Enclosed: $75.00

Print and mail with a check (made payable to WAGA) for membership dues ($75.00) to:

WAGA
1025 Montgomery Highway, Suite 210
Birmingham, AL 35216