JACKSONVILLE AREA GOLF ASSOCIATION
CITY AMATEUR CHAMPIONSHIP ENTRY FORM

Check one:
 Exempt     Non-exempt

Your name    
No. & Street     
City & State  Zip
Your club     Hdcp Index
Phone No.     Email

Enclosed is a $200 check or money order payable to JAGA

Optional contribution to JAGA Scholarship Fund $

Verify your entries above then print this form.  Send it and your payment to: