Membership application
Application instructions:
1. Fill out the form completely and legibly -- you can fill it
out on screen and then print it.
2. After reading the code of
ethics, sign and date the application where indicated.
3. Enclose check for a full year's dues or indicate credit card
number.
4. Please allow up to 4-6 weeks for processing.
Important: No application will be considered
without dues enclosed or valid credit card information.
| Select the appropriate member class:
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Class SM -- Superintendent member -- To qualify, an applicant must be, at the time of application for membership, a golf course superintendent at a golf facility and does
not meet the additional qualifications for Class A. Superintendent members shall have all of the privileges of the Association,
except holding office. -- Annual
dues - $320
Class C -- Assistant superintendent --
To qualify an applicant must be at the time of application
for membership, an assistant to a golf course superintendent,
and shall be presently employed in such capacity. Class
C memberships shall have all of the privileges of the Association,
except voting and holding office. -- Annual dues - $160
Class AS -- Associate member -- To qualify,
an applicant must be currently employed by a superintendent on the grounds crew at a golf course and does not qualify for membership
under Class A, Superintendent Member or Class C by laws definition. Associate members shall have
all of the privileges of the Association, except voting
and holding office. -- Annual dues - $160
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| Applicant information: |
| Preferred mailing address: |
Home
Golf Course
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Ms.
Mr.
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| Name: |
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| Home address: |
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| City: |
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| State: |
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| Postal code: |
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| Country: |
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| U.S. Citizen?: |
Yes
No |
| Date of birth: |
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| Home phone number: |
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| Home fax number: |
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| E-mail: |
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| Education information
(please indicate highest level of education earned): |
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| Employment information: |
| Golf course: |
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| Address: |
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| City: |
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| State: |
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| Postal code: |
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| Country: |
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| Phone number: |
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| Fax number: |
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| E-mail: (*required) |
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| Title of position: |
Golf Course Superintendent
Superintendent/Owner
Asst. Golf Course Superintendent
Grounds Crew:
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| Date started position: |
Month Day
Year
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| Type of golf course: |
Daily fee/public
Private
Semi-private
Municipal |
| Number of holes: |
9
18
27
36
45
Other, please specify:
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| Immediate past employment: |
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| Title of position: |
Golf Course Superintendent
Superintendent/Owner
Asst. Golf Course Superintendent
Grounds Crew:
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| From (month/yr): |
To (month/yr):
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| City: |
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| State: |
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| Past employment: |
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| Title of position: |
Golf Course Superintendent
Superintendent/Owner
Asst. Golf Course Superintendent
Grounds Crew:
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| From (month/yr): |
To (month/yr):
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| City: |
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| State: |
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Dual membership requirement (Golf Course Superintendents only):
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Notice: All applicants
for Superintendent member membership must also be a member
of a GCSAA Affiliated Chapter. If you are choosing to maintain
an individual vote, please remember that you must be present
at the annual election to cast your vote or you must assign
your vote to a proxy.
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| Are you a member of a GCSAA-affiliated chapter? |
Yes
No
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| Name of chapter: |
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Vote will automatically go to chapter unless marked individual.
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Individual
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| Life insurance beneficiary: |
| All members (excluding non-U.S. citizens, and the following member classifications: Student, Affiliate Company, Technical Assistance Network and International Superintendent Member) are automatically enrolled into the dues term life insurance group policy. This benefit is at no additional cost to you - GCSAA pays for this benefit. |
| Insurance policy information |
| Name of beneficiary: |
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| (Please print the first and last names, e.g.,
"Mary Smith" not "Mrs. J. Smith" or "Mrs.
John Smith.") |
| Relationship to member: |
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| Applicant signature: |
| I hereby submit my application for membership in the Golf Course Superintendents Association of America and attach my dues for one year in advance. It is estimated that 8% of my membership dues will be used for advocating positions on government issues, as well as payment of dues term life insurance for all members, excluding non-US citizens, student, affiliate company, technical assistance network, and international superintendent member, and that a portion is therefore not tax deductible as a business expense. I have read and agree to abide by the GCSAA Code of Ethics. (Visit org to access a copy of the Code of Ethics.) |
Signature:
___________________________________________________ |
| For GCSAA Office Use Only:
___________________________
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Date:
___________________________________________________ |
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| Method of payment: |
| Card type: |
VISA
MasterCard
American Express |
| Cardholder name: |
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| Card No.: |
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| Exp. date: |
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Check or money order (U.S. dollars drawn on U.S. bank) to:
GCSAA, P.O. Box 219004, Kansas City, MO 64121-9004
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