Pro Duffers West Golf Club
P O BOX 5976, OXNARD, CA 93031

Membership Application

DATE:_____________

Last Name:________________________________________________________

First Name:________________________________________________________

Street Address:_____________________________________________________

City:________________________________________  Zip Code: ____________

Home Phone:______________________________________________________

E-Mail:___________________________________________________________

Occupation (Or Retired):____________________________________________

Business Name and Address (Or Retired):_____________________________

_________________________________________________________________

Work Phone:______________________ Cell Phone:______________________

Spouse’s Name:_____________________________  Handicap? _____________

Or Avg Score: ______________  Submit five or more score cards (#):________

List the Pro Duffer West Club Member(s) you are acquainted with below:

1. Name_____________________________________ How Long?:_________
2. Name_____________________________________ How Long?:_________
3. Name_____________________________________ How Long?:_________

Please forward application with membership fee to above address