Handicap Verifcation Form

           Name ______________________________________________________

 Street Address ______________________________________________________

           City ___________________  State __________  Zip ___________

          Phone ___________________ E-Mail ___________________________

Social Security ________-_____-___________         Handicap __________


                _____________________________________  Date __________
                           Student Signature



PGA Professional or Golf Coach ______________________ Date ___________
                                   (Please Print Name)

          Phone ___________________ E-Mail ___________________________

                _____________________________________  Date __________
                      Student Confirms Handicap