Fairfield Seniors Golf Association

2010 Application 

The annual dues for the Fairfield Senior Golf Association members for the year 2010 will be $40.00 ($25 if you’re also a member of the Men’s Club), and must be received by April 7^th to allow time to prepare the flights. Early payment would be appreciated. Handicaps will be provided by CSGA. Please return this completed sign-up sheet and check made out to F.S.G.A to Ronald Wayne at the address below. 

Returning members – Fill out BOLD areas ONLY, sign and return with check.   New members – Fill out COMPLETELY, sign and return with check. 

Name, Print_______________________________________Tel#_________________ 

Address ________________________________________________________________ 

City_____________________________________________ Zip____________________ 

League Choice: 18 hole (Mon)_____18 hole (Wed)____ 9 hole (Wed)_____

Are you also a member of the HSR Mens Club       Yes______No______ 

Specify 18 hole handicap (New members only) _______GHIN #___________________ 

Date of Birth_______________  e-mail address______________________________ 

Signature___________________________________Date_______________________ 

Return completed sign-up sheet w/payment made out to FSGA to:

                                                                 Ronald Wayne

                                                         1680 Cross Highway

                                                          Fairfield, CT 06824

                                                              (203) 362-8084