First Name
Address
City
State/Prov
Select One AE AK AL AP AR AS AZ CA CO CT DC DE FL FM GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MP MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY AB BC MB NB NF NT NS ON PE QC SK ST YT Other
Zip/Postal Code
E-mail
Phone
Approximately how far do you live from our club?
Select One Under 30 Miles 31-50 Miles 51-75 Miles 76-100 Miles Over 100 Miles
Gender
Select One Male Female
What is your age?
Select One Under 20 20-30 30-40 40-50 50-60 60+
What is your approximate annual income?
Select One Under 50,000 50,000-75,000 76,000-100,000 101,000-150,000 151,000-250,000 250,000+
Handicap
Have you been here before?
Select One Yes No
How often do you play at our club?
Select One Never Have 1-5 times a year 6-10 times a year 11-20 times a year Over 20 times a year Whenever there is a deal
Are you a member of a club?
Select One Yes No
If yes, which one?
Are you interested in becoming a member of our Golf Club?
Select One Yes No
Do you normally play as a ___?
Select One Single Twosome Threesome Foursome Over Four
Does your spouse/partner play?
Select One Yes No
How many lessons do you take a year?
Select One None 1-2 3-5 6-10 More than 10
How many times a month do you play?
Select One 1 2 3 4 5 6 7 8 9 10 10+
When do you usually play?
Which days of the week do you like to play golf?
How much do you typically pay for a round of golf?
Select One Under $30.00 $31-$40 $41-$50 $51-$60 $61-$70 $71-$80 $81-$90 $91-$125 $125+
What is the number one factor that influences your decision to play golf at a club?
What is the number two factor that influences your decision to play golf at a club?
Which golf courses do you play?
What ball do you typically play?
What brand of driver do you use?
What model putter do you use?
Does your company host outings or corporate events?
Select One Yes No
Approx. Number of Participants
1-32 33-70 71-100 101-150 151-250
What is the name of your company/business?
Where do you take your golf vacations?
Additional Notes
