Asian Professional Golfers Association

THE 2004 ASIAN PGA TOUR QUALIFYING SCHOOL
APPLICATION FORM

1. NAME *

2. HOW DO YOU WISH TO BE KNOWN IN THE DRAW?

3. NATIONALITY *

4. CLUB / ATTACHMENT *

5. MAILING ADDRESS (for correspondence) *

6. TEL No:

Home
Mobile
Business

7. EMAIL ADDRESS *

8. DATE OF BIRTH *

9. INFORMATION

(a)

Are you a professional?

Yes, I'm a professional.

No, I'm an amateur.

(b)

If Amateur -

Current Handicap

Certificate enclosed as attachment

(c)

Of which PGA are you a member?

(d)

Have you played in the QS before and when ?

Yes, I played on

10. APPLICATION FOR * Stage 1 (7th - 10th Jan 2004) Final Stage (14th - 17th Jan 2004)

11. EXEMPTIONS

I claim exemption from Stage 1 because of category

A	C	E	G	I	K	M
B	D	F	H	J	L

12. PAYMENT * I am paying by cheque bank transfer

I acknowledge the sole authority of the Tournament Committee and Board of the Asian PGA Tour to establish the Qualifying School Rules and Conditions as published in this application for entry and agree to abide by these and any amendments made by them or persons acting with their authority, that may from time to time be made.

I accept that I will abide by the decisions of the Tournament Committee, Board of Directors, Executive Director, Qualifying School Tournament Director or other authorised person.

I certify that I will conduct myself in accordance with the Code of Behaviour of the Asian PGA Tour.

Date: 11-Mar-2010

Need help or advice on how to enter?

Contact Ms Kala Ramanathan or Ms Putri, Qualifying School Entries Department Tel: +603 7625 0088
Email: kala@asianpga.com, putri@asianpga.com

Need help or advice on how to pay?

Contact Ms Irene Yeo, Accounts Department Tel: +603 7625 0088
Email: irene@asianpga.com

Send completed Entry Form & Payment to:

Asian PGA Berhad
Entries Department
415 & 416, Block A
Kelana Business Centre
97, Jalan SS 7/2
47301 Petaling Jaya
Selangor
Malaysia
Fax: +603 7625 0087

* denote required fields.

Q SCHOOL 2004

Introduction

Application Form

Travel Information