CLUB THAILAND INTERNET APPLY Please write to alphabet.

NAME

FIRST NAME Mr.　　Ms. FAMILY NAME

HOME ADDRESS・TEL・E-MAIL ADDRESS

HOME ADDRESS

HOME ADDRESS

TEL TEL： 　　FAX：

E-MAIL ADDRESS

COMPANY ADDRESS・TEL

COMPANY NAME

OFFICE ADDRESS

OFFICE ADDRESS

TEL TEL： 　　FAX：

CARD

<NEW MEMBERSHIP for CLUB THAILAND>

Clubthailand Card (available in Thailand) Admission Fee (300B)+Membership Fee (1,680 B)+VAT (7%)=2,118.60 B

the available period 1 year(2,118.60 B)　　 2year(3,556.68 B)　　 3year(5,174.52 B)

〈Continuation/Renew (within a month from expiration)〉

MEMBERSHIP ID NUMBER 　sample　12345678

Clubthailand Card (available in Thailand) Membership Fee (1,680B)+VAT (7%)=1,797.60 B

the available period 1 year(1,797.60 B)　　 2year(3,235.60B)　　 3year(4,853.52B)

CARD DELIVELY

CARD DELIVERY Home　Office

PAYMENT

BANK CASH (down town Bangkok such as Silom ,Sukhumvit area)

OTHERS

Golfers Insurance hope to golfers insurance REMARKS

Please check again for any missing