2009 Pre-Qualifiers

5/11 Nashua CC
5/19 Sagamore-Hampton GC
5/28 CC of NH
6/2 Nippo Lake GC

6/4 Dublin Lake Club (walking only)
6/9 Abenaqui CC
6/11 Granite Fields GC
6/15 Concord CC

6/22 Eastman GL
6/24 The Maplewood GC

106^th STATE AMATEUR CHAMPIONSHIP

JULY 13 - 18, 2009

Cochecho Country Club - Dover, NH

Entry Fee - $110

PLAYERS EXEMPT FROM PREQUALIFYING FOR 2009:
Dan Arvanitis, Rich Berberian, Jr., Matt Burroughs, Jim Cilley, Craig Cyr, Austin Eaton III, Chris Farrar, Ryan Friel, Seth Girouard, Ryan Henry, Andy Hunnewell, Camrin James, Peter Keilty, Stephen Kozlowski, Robert Landry, Jr., David Larrivee, Gary Lewis, Nick MacDonald, Derek McAllister, Bob Mielcarz, Patrick Pelletier, James Pleat, Brian Prescott, Craig Steckowych, Mark Stevens, Tim Strout, David Walde, and Brett Wilson.

Enclose entry fee payable to NHGA and send payment to:

New Hampshire Golf Association, P.O. Box 486, Wolfeboro, NH 03894

PLEASE PRINT AND COMPLETE EVERY BLANK

NAME ____________________________________________________________

ADDRESS ______________________________________________ PHONE _________________________

CITY ________________________________________ STATE _________ ZIP _______________________

CLUB __________________________________________________

EMAIL ADDRESS _________________________________________

GHIN NUMBER (NOT HANDICAP INDEX) __________________________ (Note: You must have an ACTIVE GHIN handicap in order to pre-qualify)

CHOICE OF PREFERRED QUALIFYING DATES: 1) __________________2)_________________3)_______________

4) __________ 5) __________ 6) ___________7)___________8)___________9)__________10)_________

_____I will want a cart for the pre-qualifier

I agree to the championship regulations on the pages of the application. I have read and understand the requirements of eligibility and for acceptance of this entry. I agree this entry is subject to approval or rejection at any time by the New Hampshire Golf Association at its discretion. All contestants must abide by the rules of the host club.

Signature of Applicant _______________________________________ Date ______________

State Amateur