2016 Lombard Trophy

Club Entry Form
Club Details
To be completed by the Club Manager and the Professional upon organisation of the Club Qualifying Round and mailed to
The PGA as soon as possible. (BLOCK CAPITALS PLEASE)
Name of Golf Club:
Address of Golf Club:
Postcode:
Tel No:
County or National Union to which Club is affiliated:
Club Qualifying Round and Regional Final Details
The following stroke play competition has been designated as The Lombard Trophy Club Qualifying Round.
Competition:
Date:
We wish to compete in the Regional Final to be held at:
To be held on:
Our alternative Regional Final is (state venue):
To be held on:
Note: You will be entered into your first choice venue unless otherwise notified by The PGA.
Club Manager Signature:
Full Name:
Competing PGA Professional Details
Full Name:
I confirm that I have read the tournament rules and conditions and I am eligible to participate. I have enclosed a cheque/payment details
for £35/€47.25 for the Club Entry.
Signature:
Date:
Entry Fee (GBP £35/€47.25)
Payment Method (Please tick appropriate box below):
Payment by Credit Card (AMEX not accepted):
A. Payment by Credit Card
Please complete details in the adjacent boxes
B. Payment by Cheque
Please make cheque payable to ‘PGA Ltd’
C. Paid via BlueGolf
Tick this box if you have paid online using BlueGolf
Please email completed entry form to: entries@pga.org.uk or using
Envelope ‘A’ provided, please return the following to:
The Lombard Trophy Tournament Office, The Professional Golfers’
Association, Courtyard 5, Coleshill Manor Office Campus, Coleshill,
Birmingham B46 1DL.
Type of card:
Name on card:
Billing address:
Card No:
Valid from:
Issue No. (Switch only):
Security Code (Last 3 digits):
Expiry Date:
Envelope ‘A’ will include: Club Entry Form Cheque or payment details
The Club Entry Form will be returned if it is not completed in full and/or
accompanied by the relevant payment details.
Approved by the R&A for the payment of expenses – Rule 4-2g RA/11/2016
®PGA is a registered trademark of The Professional Golfers’ Association Limited.
For The PGA Use Only
Pro Elig:
Club Fee:
Club Elig:
BG: