HERNDON GOLFERS CLUB

P.O. BOX 146

HERNDON, VA  20172

 2010 Membership Application Form

 NAME:_______________________________________________________

ADDRESS:  ________________________________ CITY:  _____________ STATE:___ ZIP:  _________

 WORK PHONE:________________ HOME PHONE:__________________

 E-MAIL ADDRESS: _____________________________________________

Please return this application form to the above address with your check payable to HGC.

Membership Fee                              $150.00

_______      Check here if over 60 and will play from white tees

Membership Fee goes towards prize fund only.  HGC maintains a separate tournament handicap system and does not rely on USGA handicaps.  If you would like to have a USGA handicap, please contact course directly.

If you are a new member and maintain a handicap at another club, please indicate this information below:

 Name of Club:  _________________________________________