ORLGA
Member Registration
Instructions:
To register as a member of ORLGA, just complete the form below and click "
Submit
".
Required entries are marked with a red star.
The "Reset" button will clear the entire form if necessary.
You will receive email confirmation of your registration.
First Name
*
Last Name
*
Home Phone Number
*
E-mail Address:
*
Street Address
*
Street Address(2)
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington, DC
West Virginia
Wisconsin
Wyoming
--Territories--
American Samoa
Federated States of Micronesia
Guam
Midway Islands
Puerto Rico
U.S. Virgin Islands
Postal Code
*
Month of Birth
January
February
March
April
May
June
July
August
September
October
November
December
Day of Birth
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Annual Dues ($20.00)
*
Yes
No
Hole-In-One insurance? $5.00
*
Yes
No
Ringers Competition? $5.00 - Must sign up by Feb. 1 of current year
*
Yes
No
Current USGA Handicap if known
Comments or Questions
*
Required
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