Cowpernicus Golf Instruction Personal Golf Inventory

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This form will help Cowpernicus and you determine your golf instruction needs. This will also serve as an application when applying for golf instruction. For details on rates and schedules please await a response via email. Thank you.

Email *

Name *

Email *

Address *

Phone number

The primary reason I wish to have golf instruction:

When I swing the club. . . *

When I hit the ball. . . *

My favorite club is.: *

I have been golfing for: *

I want to get better at: *

I golf on the course: *

I have not yet been on a golf course

once a week

twice a week

up to 5 times or more per week

Other:

I practice at the range: *

once in a while

before every round

once a week

never

Other:

The Primary complaint I have for my golf game is: *

Distance

Accuracy

Scoring

Comfort

Injury

Equipment

Other:

I am interested in: *

A single lesson

A group lesson

A short series of lessons

A playing lesson (play a series of holes on a course)

A combination of the above

Please contact me by: *

phone

text

Send me a copy of my responses.

Submit

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