Please print out the following application
and fax or mail it to The Academy.

NAME:__________________________________________________________________________
ADDRESS:______________________________________________________________________
CITY:__________________________________		PROVINCE:_____________________________
POSTAL CODE:_________________________
HOME PHONE NUMBER: (        )_____________________________
CELL/PAGER NUMBER:   (        )_____________________________
FAX NUMBER:                  (        )_____________________________
E-MAIL ADDRESS:_______________________________________________________________
MALE	FEMALE		JUNIOR AGE:_____________
EQUIPMENT NEEDED?  YES   NO
NOVICE	INTERMEDIATE		ADVANCED
GOLF SCHOOL PROGRAM:________________________________________________________
DATE:__________________________________
PAYMENT OPTIONS
VISA	MASTERCARD		AMERICAN EXPRESS
CARD NUMBER:_________________________________________________________________
EXPIRY DATE:___________________________________________________________________
TOTAL CHARGE:_________________________________________________________________
SIGNATURE:_____________________________________________________________________
* APPLICABLE TAXES APPLY TO ALL INSTRUCTIONS

 

Fax or Mail to the address below:

2075 SALEM ROAD
AJAX, ONTARIO
CANADA
L1S 4S7

FAX: (905) 427-5981