FORT BELVOIR RETIRED MEMBERS' GOLF ASSOCIATION

Membership Application

                                                                                                        date:______________

full name                                                                                                                                                                                            

home address                                                                                                                              

                    street                                           apt#                                            

 ______________________________________________________________________

 city                              state                                 zip code                         

 e-mail address  _____________________________________________

phone  No (______)_________________­­­__ 

date of birth_________________________

date retired from military service_____________   branch___________

The FBRMGA is an Association for the retired military, and for retired DOD employees as associate members.  Applicants must be 55 years or older and must be annual patrons of the Fort Belvoir Golf Club to join and play in our matches.  Members must pay the club for handicap service.  Annual dues are $10.00.  Please submit this application and your check payable to FBRMGA to: Chris Tragakis, 6831 Camus Place, Springfield, VA 22152

Sign Here ______________________________