Register as Lady Captain

Question Title

* 1. About You...

Title:

First Name:

Last Name:

Question Title

* 2. Address

House Name or Number:

Street:

Town:

County:

Postcode:

Question Title

* 3. Are you Lady Captain for 2019, 2020 or 2021?

2019

2020

2021

Question Title

* 4. I would like a brochure

Main gifts brochure

Lady Captain 2020 brochure

No thanks

Question Title

* 5. Email Address:

Question Title

* 6. What club will you become Lady Captain of?

Question Title

* 7. What county is your golf club situated in?

Question Title

* 8. How many lady members does your golf club have?

0

300

Clear

i We adjusted the number you entered based on the slider’s scale.

Question Title

* 9. When does your term start?

DD/MM/YYYY

Question Title

* 10. When is your Lady Captains Day?

DD/MM/YYYY

Question Title

* 11. How did you hear about Surprizeshop?

Question Title

* 12. By completing this form you are asking to be added to our list and will be sent emails and brochures from Surprizeshop. If this is not your intention and you do not wish to receive these from us please abandon this form and do not press done.