The Clubhouse
Name:
Address:
City:
State:
Zip:
Main Phone:
Alternate Phone:
Email:
Fax Number:
How did you hear about
Natural
Golf Certified Instructor
Program:
<Select>
Infomercial
Video
Book
Natural Golfer
student
Other
Handicap:
Can you provide proof of said
Handicap?
<Select>
Yes
No
Are you currently teaching?
<Select>
Yes
No
If yes, how many years?
Are you PGA?
<Select>
Yes
No
If yes, please fill in the following:
Class:
Member Number:
Years as a member:
If no, please answer the following:
Other golf teaching certification?
Years as a member:
Name of your current teaching facility?
Contact Name:
Contact Phone:
Address:
Phone Number:
Fax Number:
Does it have a course?
<Select>
Yes
No
If yes, please answer the following:
Number of holes?
Lights?
<Select>
Yes
No
Sand?
<Select>
Yes
No
Chipping Area?
<Select>
Yes
No
Targets on range?
<Select>
Yes
No
Is it:
<Select>
Public
Private
Does it have a driving range?
<Select>
Yes
No
If yes, is it:
<Select>
Indoor
Outdoor
<Select>
Grass
Mats
How many hitting stalls?
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