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Please give this application and a check for $50 to the EMPIRE RANCH SENIOR MEN'S GOLF CLUB TREASURER, mail it to the Empire Ranch Golf Course,1875 Fair Way, Carson City, NV 89701 or drop it off at the pro shop. Make your check payable to SENIOR MEN'S CLUB.


            EMPIRE  RANCH SENIOR MEN'S GOLF CLUB  - 2019 MEMBERSHIP APPLICATION

NAME:   ___________________________________________ 

DATE OF BIRTH:   _______________________

ADDRESS:   ________________________________________________________________________________
 
 City  ________________________       State    ______________                       ZIP Code    _____________

E-MAIL   ______________________________________ 

HOME PHONE     (____)________________________

GHIN # _________________________    Were  you a member of the Club in 2018?      Yes (    )         No (    ) 
 




DATE  RECEIVED:                                            CHECK  NO:                                       DEPOSITED: