(Please read the entire form before signing and returning)


Club Membership dues for Year 2018 are $81.00 ($42 Club, $39 NCGA) for Regular Member and $45.00 for Social Member.  Dues are delinquent after December 31, 2017.  After December 31st, the fees go up $10.00 to $91.00 for Regular Member and $55.00 for Social Member.  Make checks payable to Shoreline Seniors Golf Club and mail with lower portion of this application to:


Bryan Shak,915 Kristin Ridge Way, Milpitas, CA 95035


------------------------------------------------Cut here------------------------------------------------------------


Name ____________________________________ Home Phone ____________

Street _______________________________City______________________ ZIP_________

Birth Date _____________NCGA# ______________ Home Club____________________

Email Address___________________________________________________


May your Email Address be published in the Membership Directory    Yes_____   No ______

I would be willing to serve on Committees    Yes _____   No _____

I would be willing to serve on the Board of Directors   Yes _____    No _____


Check one category (applying for): Regular Member _____   Social Member _____


In applying for renewal, you agree to; (1) comply with the By-Laws, Rules and Procedures of this Club; (2) abide by all agreements that have been entered into by said Club and all agreements that the Board of Directors of this Club enter into subsequent to the date of application and (3) serve as a greeter at least once a year, as of the date of application.