PLEASE READ THE FOLLOWING THREE INSTRUCTIONS NOTES CAREFULLY. ONCE YOU’VE COMPLETED THE FORM, CLICK THE “SUBMIT” BUTTON and THEN SEND YOUR MEMBERSHIP RENEWAL PAYMENT TO:

JOHN KAWAMOTO

Club Treasurer

1121 Marlin Avenue

Foster City, CA 94404

NOTE 1: For your membership to remain current for next year, you must complete and submit this form on or before DECEMBER 15 of this year.

NOTE 2: Please send a mug shot of yourself to Tom Yamashiro, Membership Committee chiarman, for inclusion in the membership directory.

NOTE 3: The NCGA requires updated contact information. Please check the Cypress Members page to make sure your directory contact information is correct. If there are ANY changes to your contact information, complete the CONTACT INFORMATION part of the form. At a minimum, you must complete the YOUR NAME, NCGA #, email address, and membership type fields.

My Name:

My NCGA GHIN number:

My E-Mail Address:

My Membership Type (Check one):

  Regular  ($110)    Associate ($80)

My Spouse’s Name:

MY CONTACT INFORMATION

 My contact information on the Cypress Golf website is CORRECT.

 Please UPDATE my contact information on the Cypress Golf website as follows:

My Address:
 Street Address
 City, State, and ZIP Code

My Phone Numhers:
 Day Phone
 Night Phone
 Cell Phone
 FAX