36 Holes Qualifying Round for the Championship and Jackson Trophy
Entry form

Surname................................................................................ Title...........................
 
First name.................................................................................................................
 
**I do not wish to proceed to the matchplay competition
 
Address....................................................................................................................

Postcode......................................................... Tel...................................................
 
Email..........................................................................................................................
 
H/C (as at 1st July 2012)................................ CDH No.......................................
 
Club I enclose cheque for............................
 
Please make cheque payable to KCLGA, DATED 31st July 2012
I would like to receive my Start Sheet by email YES/NO
or I enclose a stamped addressed envelope for my Start Sheet

No refunds if cancellation is made within two weeks of the competition

The draw will take place immediately following the closing date.
Entries will be restricted to 42.
Higher handicaps may be balloted out

HANDICAP CERTIFICATES MUST BE PRODUCED.

Please advise any special dietary requirements

**Please put an X if applicable