67^th STATE JUNIOR CHAMPIONSHIP

JUNE 23, 24 and 25, 2008

CAMPBELL’S SCOTTISH HIGHLANDS - SALEM NH

Enclose entry fee of $25 payable to NHGA

Send payment to:

New Hampshire Golf Association, P.O. Box 486, Wolfeboro, NH 03894

Please print and complete every blank

NAME _________________________________________ DATE OF BIRTH _______________

ADDRESS __________________________________________PHONE ___________________

CITY ___________________________________STATE ________ ZIP __________________

CLUB ___________________________________________

EMAIL ADDRESS ______________________________________

GHIN NUMBER (NOT HANDICAP INDEX) ____________________________

______ I do not want my picture on the web-site

I agree to the championship regulations on the pages of the application. I have read and understand the requirements of eligibility and for acceptance of this entry. I agree this entry is subject to approval or rejection at any time by the New Hampshire Golf Association at its discretion. All contestants must abide by the rules of the host club.

Signature of Applicant _______________________________________ Date ________________

Junior