NCGA Credit Request Form
Golfers in question MUST be removed from the club’s active roster before any credit request will be considered.

Example - Regular to Junior? Merely edit the membership type and add a birth date; do not delete.
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Club Name *
Club Number *
Club Contact Name *
E-mail *
Phone *
All credits are subject to the approval of the NCGA
1) Golfer Name *
NCGA/GHIN Number *
Date Inactivated *
MM
/
DD
/
YYYY
Amount Billed *
Reason *
2) Golfer Name
NCGA/GHIN Number
Date Inactivated
MM
/
DD
/
YYYY
Amount Billed
Reason
Clear selection
3) Golfer Name
NCGA/GHIN Number
Date Inactivated
MM
/
DD
/
YYYY
Amount Billed
Reason
Clear selection
4) Golfer Name
NCGA/GHIN Number
Date Inactivated
MM
/
DD
/
YYYY
Amount Billed
Reason
Clear selection
5) Golfer Name
NCGA/GHIN Number
Date Inactivated
MM
/
DD
/
YYYY
Amount Billed
Reason
Clear selection
6) Golfer Name
NCGA/GHIN Number
Date Inactivated
MM
/
DD
/
YYYY
Amount Billed
Reason
Clear selection
7) Golfer Name
NCGA/GHIN Number
Date Inactivated
MM
/
DD
/
YYYY
Amount Billed
Reason
Clear selection
8) Golfer Name
NCGA/GHIN Number
Date Inactivated
MM
/
DD
/
YYYY
Amount Billed
Reason
Clear selection
9) Golfer Name
NCGA/GHIN Number
Date Inactivated
MM
/
DD
/
YYYY
Amount Billed
Reason
Clear selection
10) Golfer Name
NCGA/GHIN Number
Date Inactivated
MM
/
DD
/
YYYY
Amount Billed
Reason
Clear selection
Submit
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