Name: 

Street Name:

City, State:          Zip: 

Phone:

Email:

Check box if you are a Junior (Age 17 or below)

If you are a Junior, please provide Date of Birth:

 

Check box if you are an existing NCGA member

If you are an existing NCGA member, please provide the following information:

What is your existing GHIN number:

What Club you belong to:

What is your current handicap?         

How did you hear about IAGA: Current IAGA Member Word of Mouth Internet Other

Name of IAGA member that sponsored you*:

* For every 3 new members sponsored by a current member, IAGA provides that member with a free tournament entry. New Members must be sponsored by a current active member. Otherwise, we encourage you to play in an IAGA tournament as a guest.
 

Credit Card Information:

Credit Card Type: Choose the following: Visa American Express MasterCard

Credit Card Holder Name:

Credit Card Number:

Credit Card Expiration: Month         Year

New Membership dues are $200.00

Comments or any requests:

By submitting your  request, you agree to this IAGA Release