2012 US Challenge Cup Membership Form                         Print Form


To become a member, please complete the following form. Print and mail the completed form with a $65.00 check made payable to:

US Challenge Cup

21 Agnes Street

East Providence, RI 02914

Please provide the following contact information and equipment info: 

Name
Street Address
City
State/Province
Zip Code
Home Phone
E-mail
Date of Birth
School
HS Graduation Date
GPA
Golf Course Affiliation
Handicap
Parents Names & Signature
  Equipment Information - be specific: 
Favorite Shirt & Size
Favorite Glove & Size
Driver
Fairway Metal
Irons
Wedges
Putter
Ball


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