NGSA CORPORATE SPONSORS

Account Information Name: (First) (MI) (Last) Address: City/State/Zip: Country: (If other than USA) (Format: XXX-XXX-XXXX) Phone: Fax: Web Site: Email: ***Please make sure your email address is correct. *** Your email address is used for both your login and for keeping you informed of any changes to your account. How many years have you been a golf sales representative? I am a (choose one) Independent Rep Company Rep Associate Please list territory covered (List all states i.e. AZ, NV, S.CA or ALL) below: Lines Carried (List All) 1) 5) 2) 6) 3) 7) 8) 4) Do you receive? Commission Only Salary Only Both Salary and Commission What additional services or benefits would you like to see the association provide? Yes Do you want to sell your apparel samples? No Select a rental car company Alamo Hertz National Other Which car rental company do you use? Select a long distance carrier ATT MCI Sprint Other Which long distance carrier do you use? What major medical insurer do you use? (Format: XXX-XXX-XXXX)

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