REGISTRATION FORM 3 Day Club Making Program Class Date (required) —Please choose an option—April 22-24 - Cost: $999.00May 13-15 - Cost: $999.00June 17-19 - Cost: $999.00July 22-24 - Cost: $999.00 Contact Name Dealer/Retailer Name Address City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareWashington DCFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennslyvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip / Postal Contact Email Certification Certificate Check all that apply regarding your background? Golf Club RepairCustom FittingRetail SalesPlayerPGA Member Do you have previous experience working with Swing Science Products? please selectYesNo