NAME:                                

BIRTH DATE:                       

SOCIAL SECURITY NO:          

STREET ADDRESS:                

CITY/STATE/ZIP:                  

STATUS:                               PRO AMATURE

AGE:                                      

HOME PHONE:                      

CELL PHONE:                       

E-MAIL ADDRESS:                 

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-ENTRIES FOR EACH TOURNAMENT MUST BE RECEIVED NO 

  LATER THAN ONE WEEK PRIOR TO EACH EVENT.

-TEE TIMES WILL BE MADE AVAILABLE THE DAY PRIOR TO THE 

  TOURNAMENT BY CALLING THE TOUR OFFICE.

-BY EXECUTION OF THIS APPLICATION, I AGREE TO ABIDE BY 

  THE TOURNAMENT RULES AND REGULATION AS SET FORTH 

  BY "THE FLORIDA SENIOR TOUR" A COPY OF WHICH HAS BEEN
  PROVIDED TO ME.