MUST FILL OUT THE INFORMATION BELOW AFTER SENDING PAYPAL PAYMENT TO COMPLETE HANDICAP ACTIVATION

$54.00

GHIN Handicap

* First Name:

* Last Name:

* Previous GHIN #:

* E-mail Address:

* Address:

* Address 2:

* City:

* State:

* Zip Code:

* Phone:

* Comments:

STERLING FARMS GOLF SHOP

HANDICAP ONLY SERVICE

PREVIOUS GHIN #: _________________

NAME: ___________________________________________________ PHONE #: ___________________________

ADDRESS: _________________________________________________________ (STREET/APT #)

_________________________________________________________ (CITY, STATE, ZIPCODE)

EMAIL: _________________________________________________________________

DOB: ______________________________ MALE / FEMALE (CIRCLE)

FOR OFFICE USE ONLY

DATE RECEIVED _______________________ PAYMENT TYPE ________________________

DATE ENTERED __________________________ ENTERED BY: _____________________________