Potential Golfer Form

Email Secondary Email

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First Name

Last Name

Email address *

Address 1 *

Address 2 *

City *

State *

ZIP Code *

Cell Phone Number *

Date of Birth

Height

SAT Score

ACT Score

GPA

Class Rank

Graduation Year

Father's Name

Father's Occupation

Father's Alma Mater

Mother's Name

Mother's Occupation

Mother's Alma Mater

Intended Major

Top Three College Choices

High School

High School Coach

High School Coach's Telephone

Number Played On Team

Tournament Scoring Average

Best Tournament Round

Golf Honors

Golf Instructor

Home Course

Notes

(For office use only)

* required field