New ______ Renewal ______ Consecutive Years in Club ______

Name:                                                                                                      

Address:                                                                                                               

City:                                           State: ______ Zip:                       

Phone:(___)__________________    Alternate(_________________________)

E-mail Address__________________________________________________

                      (for Newsletter/ Activities/ Information - Update if Renewal)

Employer__________________________Phone:__________________________

Single___Married___

Spouse's Name:__________________________________

Name & Age of Children 16 & under____________________________________

_________________________________________________________________

Pro Guide Yes___No___ Other Civic Groups_____________________________

Special Talents that could be useful in this club:__________________________

__________________________________________________________________

NOTE: PPSFC , Tournament Director and place of club event will not be liable for any person or personal property damage that may occur at any participating club event. Payment of club dues constitutes a direct repease of liability.

As a member of the PPSFC , I have read the tournament ruels and the by-laws. I promise to conform to the laws of the club and state of TN. In accepting membership, I agree to endeavor to attend it's meetings regularly and will at all times strive to uphold and promote PPSFC aims and goals.

Signature:_______________________________                                               Date:___________________

Mail Application to : Dennis Shipp 2412 Maplecrest Dr.  Nashville, TN 37214