SIME DARBY LPGA DEVELOPMENT PROGRAM 2012

APPLICATION FORM

A) Player's Particulars * Full Name :
* Age :
* NRIC (no hyphens) :
* Date of Birth :
* Telephone (Mobile):
* Email :
* Address :
Current School/Occupation :
School/Employer Telephone :
Home Club :
* NHS Number :
* Current USGA Handicap Index :
World Ranking (WAGR) :
Low Round (18 holes) :
Race : Malay Indian Chinese Others
T-Shirt Size(Ladies) : S M L XL
Current Coach :
How long w Current Coach : Years Months

Other Coaches :
Father's Name :
Father's Telephone(Mobile) :
Mother's Name :
Mother's Telephone(Mobile) :

Parent's Email(either Father or Mother's) :

Food/Medicine Allergy :

B) COMPETITION & SCORES
#1 Competition Name
Year
Day 1 : Day 2 : Day 3 :

#2 Competition Name
Year
Day 1 : Day 2 : Day 3 :

#3 Competition Name
Year
Day 1 : Day 2 : Day 3 :

#4 Competition Name
Year
Day 1 : Day 2 : Day 3 :

#5 Competition Name
Year
Day 1 : Day 2 : Day 3 :

#6 Competition Name
Year
Day 1 : Day 2 : Day 3 :

#7 Competition Name
Year
Day 1 : Day 2 : Day 3 :

#8 Competition Name
Year
Day 1 : Day 2 : Day 3 :

#9 Competition Name
Year
Day 1 : Day 2 : Day 3 :

#10 Competition Name
Year
Day 1 : Day 2 : Day 3 :

C) Info Accommodation Required :

Yes No (Only for Outstation Players)

Attendance Week 1 :

Yes No Maybe (starts Monday, July 8th)

Attendance Week 2 :

Yes No Maybe (starts Monday, July 15th)

Attendance Week 3 :

Yes No Maybe (starts Monday, July 22nd)

Attendance Week 4 :

Yes No Maybe (starts Monday, July 29th)

Attendance Week 5 :

Yes No Maybe (starts Monday, Aug 12th)

Attendance Week 6 :

Yes No Maybe (starts Monday, Aug 19th)

Attendance Week 7 :

Yes No Maybe (starts Monday, Aug 26th)

Attendance Week 8 :

Yes No Maybe (LPGA Qualifier, Sept 5 & 6th)

Additional Training :

Yes No Maybe (only for Qualifiers)

Have you attended previous SDLPGA Development Program :

2010 2011 2012

Played in Sime Darby Qualifying Round Qualified

Objective of Joining :

Note : A 500 Ringgit deposit will be collected upon confirmation and acceptance of entry to the Sime Darby LPGA Development Program. Deposit will be fully refunded at the end of the program with the condition that the player fulfilled the player’s contract. Player’s contract will be provided once you are being offered an entry to the program.