Name:
Address:
City:
State:  Zip: 
Main Phone:
Alternate Phone:
Email:
Fax Number:
How did you hear about Natural
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Program:
Handicap:
Can you provide proof of said
Handicap?
Are you currently teaching?
  If yes, how many years?
Are you PGA?
  If yes, please fill in the following:
    Class:
    Member Number:
    Years as a member:
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    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?
  If yes, please answer the following:
    Number of holes?
    Lights?
    Sand?
    Chipping Area?
    Targets on range?
    Is it:
    Does it have a driving range?
      If yes, is it: 
    How many hitting stalls?

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