Register

Membership Application Form

Please fill out the information correctly and completely. (* Required)

Personal Information

Name (Thai) *
Surname (Thai) *
Name (English) *
Surname (English) *
Nickname *
Nationality *
ID Card *
Sex *
Male Female
Date of Birth *
Phone *
Email *
Place of education *
High school graduation year (A.D.) *
Shirt size *
Shirt size table / inch

SIZE 8 10 S M L XL XXL 3XL

Male 40" 42" 44" 46" 48" 50"

Female 32" 34" 36" 38" 40" 42"

Kids 30" 32"

Address

House number *
Road
Village
City *
State
Country
Postcode *

Parent information

Father's name *
Surname *
Phone *
Email *
ID Line
Occupation

Mother's name *
Surname *
Phone *
Email *
ID Line
Occupation

Pro Trainer

Name of trainer
Institution

Photo

Attach photos of golfers *
Annual membership fee 2,500 Baht

KASIKORNBANK Public Company Limited (KBANK), Fashion Island Branch
Account Number : 056-8-08937-5
Account Name : Golf Impact Center Co., Ltd.

For wire transfer:
Swift: KASITHBK
Address: KASIKORNBANK Public Company Limited (KBANK)
1 Soi Kasikornthai Ratburana Rd, Bangkok 10140
Tel: 0-2222-0000
Request tax invoice

Company Name *

Tax ID *

Address *
Attach proof of payment *