FLATONIA GOLF ASSOCIATION
						P.O. BOX 391
						FLATONIA, TEXAS 78941
						2011 MEMBERSHIP APPLICATION
	NAME ___________________________________________________________________
	MAILING ADDRESS _______________________________________________________
	CITY _______________________________________ STATE _______ ZIP ___________
	TELEPHONE NUMBERS:  Home ____________________________________
				Cell _____________________________________
	E-MAIL ADDRESS:  _____________________________
	TYPE OF PAYMENT (check one) CASH ________  CHECK _______
	MEMBERSHIP - Family $400.00
		__	Single payment $400		__	Semi-annual, $200	__	Quarterly $100
						2 Checks		4 Checks
	MEMBERSHIP - Student $100.00      (Single payment only)
	CART SHED RENTAL - $200.00					SHED NO. _____
		__	Single payment $200		__	Semi-annual, $100	__	Quarterly $50
						2 Checks		4 Checks
	DRIVING RANGE MEMBERSHIP    (Single payment only)
		__	Family $110.00		__	Individual $80.00
	TRAIL FEES $50.00     (Single payment only)
	FAMILY MEMBERS
		Note: List the names of household family members and include ages of children:
		Name						AGE
		___________________________________________						_________
		___________________________________________						_________
		___________________________________________						_________
		___________________________________________						_________
		___________________________________________						_________
	SIGNED _____________________________________						DATE ____________