EGU Northern Counties Group

Name (Block Capitals)......................................................................................
Address.................................................................................................................
.............................................................................................................................. 
Post Code.......................................................Tel:..............................................
Date of Birth.............................................       Home Club........................
Email....................................................................................
Handicap........................(Limit 12)  
CDH (Unique Lifetime ID Number......................................
(Signature of your Club Secretary is only needed if you do not have a CDH number)
The CONGU Unified Handicapping System 20012 - 2015 (Appendix B 2.4) requires entrants to notify the organising committee if they are a member of the hosting club even though that club is not their Home Club.   Please put an x if this applies. [   ]  All player's must have a CONGU "active" handicap.

I am eligible to compete under the conditions of the Championship.  
I enclose a cheque for £35 in payment of the Entry Fee.  ( Cheques made payable to E.G.U Northern Counties)  
OR by electronic payment to account no: 40385701 sort code:013099 . Use your surname as reference

I certify that the handicap of Mr...........................................is....................(Limit 12) under the conditions of the CONGU Unified Handicapping System (Effective 1st January 2012) and to the best of my knowledge he is of Amateur Status as defined by the Royal and Ancient Golf Club of St. Andrews.

Signed.................................................................
Secretary................................................................Golf Club