Michigan Seniors
Golf Association

Application

You may complete this application online using the form below or by dowloading the application here. Then you may either fax or mail it to The Michigan Seniors Golf Association.

Word Application Adobe PDF Application

MICHIGAN SENIORS GOLF ASSOCIATON

MEMBERSHIP APPLICATION

First Name:
Last Name:
Date of Birth:
Address Street 1:
Address Street 2:
City:
Zip Code:	(5 digits)
State:	Michigan
Occupation:
Current Club Affiliation:
Wife's Name:
Preferred Phone:
Email:
GAM Number:
Prior Club Affiliation:
Years you were a member:
Sponsor:
MSGA Members Known:
	I authorize the Michigan Seniors Golf Association to verify all statements and representations made by me or on my behalf. If accepted, I agree to abide by the rules of the Association and know that the initiation fee of $200 and the first year’s dues of $110 are non-transferable and non-refundable.

Michigan Seniors Golf Association
3707 West Maple Road, Suite 110, Bloomfield Hills, MI 48301
Office: 248.642.8470 Fax: 248.644.4526

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