2005 ASGA Mid-Amateur/Mid-Senior/Public Links Championship
The Course at Eagle Mountain
Batesville, Arkansas
Entry Form

Name   Age on October 1    GHIN Number

Address    City  State   Zip

I am a member of   club or golf association and my handicap is  .

Date of Birth    Saturday tee time request 

 Email Address   

Reserve a cart for me         Yes            I will walk 

(Check one or all that apply- READ CAREFULLY)

Please enter me in the:                                                    Entry Fee

ASGA Mid-Amateur   ( Ages 25 +)                             $ 90.00

ASGA Mid-Senior       (Ages 40-54)                            $ 90.00

ASGA Mid-Am & ASGA Mid-Sr. (Ages 40-54)         $180.00

ASGA Public Links                                                       $  75.00

ASGA Mid-Am & ASGA Public Links                        $165.00

ASGA Mid-Senior & ASGA Public Links                   $165.00

All Three Events                                                           $255.00

Total amount submitted

Player who desire to participate in more than one event will have the opportunity to earn points from all events entered as well as gift certificates from those events.  A practice round is available to contestants on Friday, September 30 with payment of a cart fee.  You will receive hotel rates and directions in the mail (or email) after you enter.  Public Links contestants must be bona fide public course players who do not belong to a private club.  Inquiries, call Jay Fox 501-455-2742.  the field is limited to the first 75 entrants who meet the eligibility requirements.  The entry deadline is Sept., 23rd.

I understand that my entry is subject to rejection at any time by the ASGA or host club.  Any questions shall be settled by the ASGA, whose decision is final.  I hereby acknowledge that the ASGA and host club are not responsible for personal injury during this championship.  I have read the USGA rules of amateur status and I conform with those in every respect.

Name    Date