New Membership Application

Name*

First Last

Club/Company*

Current Position

Address*

Street Address Address Line 2 City State ZIP Code

Office / Phone*

Mobile / Cell Phone

Email Address*

Member of G.C.S.A.A.*

G.C.S.A.A. Number

Class Applying for*

For complete class description visit www.ogcsa.com under By-laws

Are you a G.C.S.A.A. Certified Superintendent?

Student

To qualify for student membership, an applicant must be enrolled full-time turfgrass student enrolled in a formal course education, or have completed his or her formal education less than (1)year prior to the date of application of membership.

College / University*

Professor / Supt. Member Sponsor*

Agreement

I hereby make application for membership in the Oregon Chapter Golf Course Superintendents Association and attach my dues payment for one year or any portion of time remaining of the current year. Dues are not prorated. Year = Nov 1 – Oct 31

EFFECTIVE July 1, 1997 each applicant for Class A or B membership must present either and application form, or evidence of membership, with the Golf Course Superintendents Association of America (GCSAA)

Signature of Applicant*

Date*