New Membership Application Membership dues pending approval Name* First Last Club/CompanyCurrent PositionAddress* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Office / Phone*Mobile / Cell PhoneEmail Address* Member of G.C.S.A.A.*YesNoG.C.S.A.A. NumberClass Applying for*Class A — Golf Course SuperintendentClass B — Golf Course Superintendent (less than 3 years)Class C — Assistant Golf Course Superintendent or crew memberAssociateStudentAffililateFor complete class description visit www.ogcsa.com under By-lawsAre you a G.C.S.A.A. Certified Superintendent?YesNoStudentTo qualify for student membership, an applicant must be enrolled full-time turfgrass student enrolled in a formal course education, or have completed his or her formal education less than (1)year prior to the date of application of membership.College / University*Professor / Supt. Member Sponsor*AgreementI hereby make application for membership in the Oregon Chapter Golf Course Superintendents Association and attach my dues payment for one year or any portion of time remaining of the current year. Dues are not prorated. Year = Nov 1 – Oct 31 EFFECTIVE July 1, 1997 each applicant for Class A or SM membership must present either and application form, or evidence of membership, with the Golf Course Superintendents Association of America (GCSAA)Signature of Applicant*Date* Date Format: MM slash DD slash YYYY Captcha
