MORE THAN 1.8
MILLION REASONS
TO BECOME
A VSGA VIP
CARDHOLDER
Since 1984, the VSGA-VIP
Scholarship Foundation has
awarded $1.85 million in
scholarship aid to more than
800 students attending college
in Virginia. In 2013, grants
ranged from $1,000 to $7,000.
Save tim
and ord e
online aer
t
www.vs
ga.org.
VIP CARD ORDER FORM
Jan. 1-Dec. 31, 2014
MR. MRS. MS.
VIP PARTICIPATION LEVELS
NAME (First / Middle Initial / Last)
$97
eClub Member
(includes membership in a VSGA eClub. eClub
members also receive a VSGA/USGA Handicap
Index along with the opportunity to play in nearly
100 VSGA One-Day events as well as all other
VSGA benefits)
$65
Supporter cardholder
$115
Supporter Couple cardholder
$150
Sponsor cardholder
$195
Sponsor Couple cardholder
$500
Gold cardholder
$33
Student cardholder
(ages 22 and under)
____/____/____
Birthdate
(for Student cardholders only)
CHECK ALL THAT APPLY
Renewal
New Cardholder
Mail your completed application to:
Virginia State Golf Association
600 Founders Bridge Blvd.
Midlo thian, Va. 23113
~OR~
Fax your completed application to:
(804) 378-2369 or (804) 378-8216
YES, I would like a personalized bag tag
w w w. v s g a . o r g
SKIP ROWLAND
SPOUSE'S NAME (if couple)
ADDRESS
CITY
STATE
ZIP CODE
COUNTRY (additional shipping and handling charges apply for orders outside the U.S.)
DAYTIME PHONE
E-MAIL
VSGA CLUB/GHIN NUMBER (if applicable)
PAYMENT INFORMATION:
CHECK (enclosed)
VISA
MASTERCARD
DISCOVER
AMEX
ACCOUNT NUMBER
EXPIRATION DATE
THREE-DIGIT SECURITY CODE ON BACK OF CARD
SIGNATURE
VSGA-VIP
SCHOLARSHIP
FOUNDATION
$7
YES, I would like to make a donation to
the VSGA-VIP Scholarship Foundation.
Amount Donated
Total Enclosed
CARDHOLDER INFORMATION Please print
$______
$______
Courses, times and dates on the 2014 VIP Card are subject to change and cardholders
are encouraged to confirm cart fees when reserving starting times. If you’re paying by
check, please make payable to ‘VSGA’ and allow up to three weeks for processing and
delivery. Online orders are generally processed and mailed within 72 hours of receipt.
Please note: 2014 VIP Cards are the property of the Virginia State Golf Association and
may be recalled or suspended if terms of the card are violated. There will be a $50 fee to
replace cards ($33 for student cards.)
VIP cardholder fees paid to the VSGA are not fully tax-deductible. Fourteen percent is paid
directly to the VSGA-VIP Scholarship Foundation, which is a qualified charitable 501(c (3)
organization. Please consult your tax advisor for further information. If you have any
questions, please call the VSGA at (804) 378-2300 or visit our website at www.vsga.org.
NOVEMBER/DECEMBER 2013 | VIRGINIA GOLFER
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