Idaho GCSA Membership Application

MEMBERSHIP APPLICATION FORM
IDAHO GCSA
P.O. Box 5003, Missoula, MT 59806
Tele: 406-273-0845 www.idahogcsa.org
idahogcsa@idahogcsa.org

Section I

Name*

First Last

Course/Company Name*

Office Mailing Address*

Street Address City State / Canadian Province Zip Code

Office/ Shop Phone*

Office/ Shop Fax

Office/ Shop Toll Free

Cell/Mobile

Date Started Present Position

Title of Position

Email Address

Type of Course

Number of Holes

I would prefer to recieve all mailings at my:*

Home Address
Office Address

Are you a licensed pesticide applicator?

Yes
No

Are you a member of GCSAA?

Yes
No

GCSAA Class & Membership Number

Are you a GCSAA Certified Superintendent?

Yes
No

Next Recertification Date

Past Positions Held (Do NOT include Present Position)

From Mo. & Yr.	To Mo. & Yr.	Place of Employment	City & State	Job Title

Home Address

Street Address Address Line 2 City State / Canadian Province Zip Code

Home Phone

Spouse's Name

Member Classification

Section II

Types of products/services offered, companies represented:

Section III

Class (E) STUDENT To qualify for student membership, an applicant must be enrolled full-time in a college or university involved in the field of turf management. Applicants must obtain the signature of their major professor or a superintendent or assistant superintendent who is a member of this association as a sponsor of their membership.

College/ University*

Signature of Major Professor/ or Supt. Member Sponsor*

Date*

Phone*

Section IV

I hereby make application for membership* in the Idaho Golf Course Superintendents Association and submit my dues payment for one year or any portion of time remaining of the current year. Dues are not prorated. (Job service only does not qualify for actual membership). Our year is January 1 – December 31.

Signature of Applicant*

Date*

EFFECTIVE JULY 1, 1997 each applicant for Class A or B membership must present either an application form, or evidence of membership, with the Golf Course Superintendents Association of America (GCSAA).

Class AA, A ,B, C members: Please complete for your Green Chairperson to receive a complimentary copy of The Perfect Lie newsletter

To

Course

Mailing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Payment

This field is hidden when viewing the form

Name on PayPal or Credit/Debit Card Account

First Last

(NOW HIDDEN 8/1/2018)

3% credit card fee

Price: $0.00

Payment Options*

Pay by credit/debit card - you do not need a Paypal account. Or select "invoice" and we will mail you an invoice to pay by check.

Payment Method

Total

$0.00

Website Proudly Sponsored By:

Section I

Section II

Section III

Section IV

Payment

Website Sponsors

Website Proudly Sponsored By:

Section I

Section II

Section III

Section IV

Payment

Website Sponsors

Search Form