Miller Golf Club Membership Form

Existing Member $75

New Member $100

First Name *

Last Name *

Nickname

Phone *

Email *

What is your average score? *

Who referred you to the club?

Member name

Email *

Payment Amount *

Season *

Payment Method *

Memo

When you are paying, on the Memo section, indicate

your name, tournament

or what you are paying for.

Members

Member	Registration date	Paid	Season	New member	Referred by
Gonzales, Gabriel	January 30, 2026	$75	2026	No
Gonzales, Abel	January 30, 2026	$75	2026	No
Hawkins, Chris	January 29, 2026	$75	2026	No
Adkins, Larry	January 28, 2026	$75	2026	No
Kiszewski , Brad	January 15, 2026	$100	2026	Yes	Buentello, Rich (Richie)
Hammer, Dylan	December 27, 2025	$100	2026	Yes	Farmer, Cliff
Hinds, Clay	December 17, 2025	$100	2026	Yes	Clark, Mike
Buentello, Rich	December 14, 2025	$75	2026	No
De La Cerda, Fernando	December 11, 2025	$100	2026	Yes
Schrade, Richard	December 11, 2025	$100	2026	Yes