Southwest Amputee Golf Association

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SWAGA

Southwest Amputee Golf Association

Regular memberships are open to any amputee who has anatomically lost a hand or foot
at a major joint ... wrist/elbow/shoulder/ankle/knee/hip.

Associate membership is available to non-amputee handicapped individuals and
anyone who desires to support the Southwest Amputee Golf Association.

To join, simply fill in the following requested information.

Date: ______________
Name:
First _______________________________ MI ______ Last ___________________________________
Spouse's Name: First _______________________________ MI ______ Last ___________________________________
Address: _______________________________________________________
City, State, Zip: ______________________________________________________________________
Phone Home: ( ____ ) __________________
            Work: ( ____ ) __________________

**** E-Mail: ___________________________________________________
Type of Amputation: ___________________________________________
Disabled Veteran? Yes _____ No _____
Date of Birth: ________________________ (optional)
SWAGA Annual Dues (Regular Member):     $10.00 _______
Annual Dues (Non-Amputee, Associate Member):     $35.00 _______
NAGA membership Renewal       $10.00 _______
First time NAGA membership     $25.00 _______
______ Please send information about NAGA and its programs.
Dues payable in United States dollars.

Make check payable to SWAGA.

Please return this form to:

SWAGA
ATTN: Roy McCoy
6813 Westover Drive
Granbury, TX 76049

Call (512) 431-2861 for more information.

SWAGA Membership Application PDF