[FrontPage Save Results Component]

Louisiana Scratch Tour

P.O. Box 256

Covington, LA 70434-0256

Tour Office:

(985) 264-6498 or (985) 264-7724

Email: lascratchtour@aol.com

2012 Membership Application

Annual Membership Dues: $125.00 

First Name:     Last Name:

Address:

City: State:    Zip:

Home Phone: Work Phone:  Other Phone:

Please include area code on all phone numbers

EMAIL ADDRESS IMPORTANT

Email Address:

Most correspondence will be through email (i.e. Tee Time, Parings, Special Events etc.)

Age:    Date of Birth: HDCP:  

Course Affiliation:

Emergency Contact

Name: Phone: 

MAIL DUES AND APPLICATION TO:

All entries must be in by Wednesday prior to the tournament

Louisiana Scratch Tour P.O. Box 256 Covington, LA 70434-0256

       Email: lascratchtour@aol.com - Website: www.lascratchtour.com