MILLER GOLF CLUB

To: All Members

Subject: 2010 Membership Registration

Please complete the membership registration form below as this will insure your being on the 2010 mailing list.

Please mail the completed form to Miller Golf Club, 604 Blue Lake Drive, Fort Worth, Texas 76103.

_____________________________________________________________________________________

2010 Membership Registration

Name: _________________________________________________________________

Address: ______________________________________City/Zip: __________________

Phone: _______________________________________

Were you a member in 2009? __________Yes __________No

If not, give your average score or handicap: ______________

Who referred you to the club? ______________________________________________

What kind of work do you do?______________________________________________

If you own a business, would you like to advertise that business on the golf club web site?______

All ads are free. Contact the web site at http://www.millergolfclub.com/ to advertise.

What is your e-mail address?_________________________________________________

Thank you in advance for information you share with the club.

Dues for prior members are $40.00

Dues for new members are $50.00

Amount Enclosed: ____________