Please refer to AppleWoodGolf.com web site for current pricing and discount information.

Print-out, complete, sign and mail this form with payment to:

AppleWood Golf Course

R.D. # 4  Box 454

Harding, PA  18643-9311

Membership Type (see web site for choices and fees): _______________________________________

Name(s): _________________________________________________________________________

Address: _________________________________________________________________________

City: ________________________________________    ST: ________    Zip: __________________

Phone #: _____________________________________    Email Address: ______________________

Check # ____________ made payable to AppleWood Golf Course or

MasterCard __    Visa __  (please select one)

Cardholders Name (please print as it appears on card): _____________________________________

Card Number: _______________________________     Expiration Date: _____/_____/_________

Signature of Cardholder: ___________________________________________   Date: _________

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