Please provide the following contact information:
 

Name: 

The Quick & Easiest Phone:

E-mail:

How long have you been playing golf?

  Please select one Just started 1 year 2 years 3 years 4 years 5 years 6-10 years 11-15 years Over 16 years

What do you score now in 18 Holes?

  Please select one Don't know Over 110 100 - 110 95 - 100 90-95 85-90 80-85 75-80 70-75 Under par

What do you want to score in 18 Holes?

  Please select one Over 110 100-110 95-100 90-95 85-90 80-85 75-80 70-75 Under par

How many times will you play 18 holes this year?

  Please select one 1 - 5 times (rounds) 5 - 10 rounds 10-15 rounds 15-20 rounds 20-30 rounds 30-40 rounds 40-50 rounds Over 50 rounds

How often will you practice?

  Please select one Never Once per week Twice per week Three times per week Once a month

Thank you for answering these questions. The rest of the assessment will be done verbally by phone or at the first lesson.