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Application Checklist Application Checklist Application Process and Checklist Submit the following to LPGA Headquarters Completed Application Form Application fee of $450 Completed Verification of Employment Form Two (2) Letters of Recommendation Proof of Education (i.e. High School or College diploma) Completed Professional Self-Assessment Form Proof of Playing Ability Test (PAT) Equivalency NOTE: If submitting PAT equivalency, include $150 PAT equivalency fee Completed Rules Test NOTE: If you took the LPGA PAT, you already completed the Rules Test and do not need to re- submit. Credit Card/ Check Information to charge Fees or you may call LPGA 386-274-6225 to provide credit card information over the phone Total Amount to Charge: $______________ Method of Payment: Check #: ______________ MasterCard Visa American Express Card #: - - - Exp. Date: / Name as it appears on the card: ___ Signature: MMMEEEMMMBBBEEERRRSSSHHHIIIPPP AAAPPPPPPLLLIIICCCAAATTTIIIOOONNN Legal Name Preferred Name Home Address City State Zip Country Home Phone Cell Phone E-mail Date of Birth Birthplace Citizenship Marital Status Spouse Former Name Race/Ethnicity: (optional) African American (not Hispanic) Asian, Asian American or Pacific Islander Caucasian (not Hispanic) Hispanic American (Not Caucasian or African American) North American Indian or Alaskan Native Other I will require accommodations under the ADA: (optional) Yes No I have the following physical and/or learning disabilities (brief explanation with medical backup required for accommodation requests) Name of Emergency Contact Phone Relationship Highest Level of Education Achieved HS AA AS BA BS MA MS Year of Degree: ___________________ MBA EDD JD PHD School: Are you caurrently a member of the: LPGA Tour No Yes Current Classification PGA of America No Yes Current Classification Member # Other Approved Golf Industry Association: No Yes Current Classification Member # Have you applied to the LPGA Teaching and Club Professional Membership before? No Yes, When? LPGA Playing Ability Test (PAT) - Successfully completed on at PAT Equivalency (Enclose proof of completion, LPGA Rules Test and $150 equivalency fee) Not required, eligible for A-2 status I, the undersigned, have carefully reviewed the information provided pertaining to the LPGA Teaching and Club Professional Membership and hereby submit application or membership. I understand that this is only an application for LPGA Teaching and Club Professional Membership and I do not have any rights or privileges including use of the LPGA logo, name, etc. The information I have provided above is factual, and I understand that falsification of information will result in application rejection. Signature Date Application for LPGA Teaching and Club Profession Membership constitutes “Forfeiture of Amateur Status” (USGA Rules of Golf) Teaching and Club Professionals 100 International Golf Drive Verification of Employment Daytona Beach, Florida 32124-1092 and References Name of Current Employer_____________________________________________________________________________________ Name of Facility Job Title Address of Facility City State Zip Country Phone Fax Type of facility: private semi-private daily fee municipal resort golf range other My primary job responsibilities include: Average number of hours per week Number of months employed in the last 12 months Employment Verification I verify that the information above is accurate and understand that falsification of information could result in application rejection. Name of direct supervisor Signature of direct supervisor Phone Number Date Signature of Applicant Date NOTE: If your current employer does not meet the minimum employment requirements, make a copy of this page and have your previous employer fill out the form as well. Two Character References Name Affiliation Phone Number Referred by Name of LPGA T&CP Member who referred you to the program: Teaching and Club Professionals 100 International Golf Drive Daytona Beach, Florida 32124-1092 Professional Self-Assessment Applicant Name Educational and Professional Background Degree/certification School/program Dates Professional Workshops/Seminars attended in the last 5 years Workshop/seminar name Dates What are your education interests? (Check all that apply) teaching coaching individuals college coaching high school coaching business management marketing computer skills Other What are your current professional goals? Where do you see yourself in 3 years? 5 years? How do you believe the LPGA can best assist you in meeting your immediate and long-term professional goals? Why do you want to become an LPGA T&CP Member? What do you believe are the benefits of LPGA T&CP Membership? In what ways do you wish to contribute to the LPGA T&CP Membership? Teaching and Club Professionals 100 International Golf Drive Daytona Beach, Florida 32124-1092 Professional Self-Assessment Professional Golf Skills Golf Shop Operations None Some Skilled None Some Skilled Starting Times Club fitting Merchandising/Display Club repair Sales Rules officiating Marketing Calligraphy Accounting/Bookkeeping Public relations Computer skills Public speaking skills Word Processing Writing skills Spreadsheets Golf car operations Graphics/Desktop Publishing Course maintenance Internet Practice tee operation Teaching Playing ability Individual lessons Other _____________________ Group lessons Junior lessons Video lessons Golf / players with disabilities Other______________________ Personal Golf Experience How long have you played and when did you start playing golf? Describe the golf instruction you have had, when did you begin instruction, how much have you had? How often do you play golf now? 3-5+ times a week 1-3 times a week 2-3 times a month other (please state) Do you have competitive experience as an amateur/professional? Has your golf equipment been “fit” for you? Yes no If yes, what system was used? Prioritize the following regarding your enjoyment of golf (1-5 with 1 being the highest): performance being outside fun the challenge social interaction other What sports (other that golf) have you excelled in? What sports (other than golf) have you played? What hobbies or activities do you enjoy most or do for fun? Have you had experience with or are familiar with: the LPGA/USGA Girls Golf program? EWGA? THE LADIES PROFESSIONAL GOLF ASSOCIATION TEACHING AND CLUB PROFESSIONALS RULES EXAMINATION VERSION #1 PLEASE PRINT THE FOLLOWING INFORMATION CLEARLY Name: Address: City, State Zip: Home Number: Work Number: E-Mail: Facility: PAT Date: Score: If participating in the LPGA PAT, please submit a completed copy of this test to the PAT administrator prior to taking the PAT. If completing PAT equivalency, please submit completed copy of this test with your membership application and required documentation. Version #1 TRUE AND FALSE Questions 1. _____ If a ball is incorrectly substituted for the ball in play, the ball so substituted is not a wrong ball but becomes the ball in play. If the mistake is not corrected as provided in Rule 20-6 and the player makes a stroke at it, he incurs a penalty. 2. _____ A competitor is responsible for the addition of scores on his/her card. 3. _____ Through the green, sand and loose soil are loose impediments. 4. _____ If a player's ball at rest is moved by another ball, the moved ball must be replaced. 5. _____ A player, out of necessity, is entitled to see the ball when playing a stroke. 6. _____ Time spent in playing a wrong ball does not count in the five-minute period allowed for searching for a lost ball. 7. _____ After following the proper procedure, a player may lift his/her ball in a water hazard to determine if it is unfit for play. 8. _____ If a player drops a ball through the green and it rolls onto, and comes to rest on the green, but not more than two club lengths nor closer to the hole than its original position, the ball shall be played as it lies. 9. _____ In exceptional individual cases, including a serious breach of etiquette, the committee may disqualify a player. 10. _____ If a competitor plays a second ball in accordance with Rule 3-3, she/he must report the facts of the situation to the Committee before returning her/his scorecard. If she/he fails to do so, she/he is disqualified. 11. _____ A player may have more than one caddie, at any one time, without penalty. 12. _____ Information on the Rules of Golf is not considered advice. 13. _____ A ball is unfit for play if its surface is scratched or scraped or its paint is damaged or discolored. 14. _____ A player’s 5 iron is damaged in the normal course of play and is unfit for play. If the player chooses to replace the club, it must be replaced with another 5 iron. 15. _____ A player may repair a ball mark on the putting green only if the ball lies on the putting green. Version #1 MULTIPLE CHOICE Questions 16. _____ In stroke play, a player plays his/her tee shot from outside the teeing ground. What penalty, if any, does the player incur? A. No penalty; play the ball as it lies. B. One-Stroke penalty; a ball must be played from within the teeing ground. C. Two-Stroke penalty; a ball must be played from within the teeing ground. D. Two-Stroke penalty; play the ball as it lies. 17. _____ In stroke play, a player by accident slightly moves his ball in play while making a practice swing on the putting green. Which of the following is correct? A. The player incurs no penalty and must play the ball as it lies. B. The player incurs no penalty and must replace the ball. C. The player incurs a one stroke penalty and must play the ball as it lies. D. The player incurs a one stroke penalty and must replace the ball. 18. _____ A player who started a stipulated round with 13 clubs wishes to add a club during the round. The player is permitted to obtain a club from: A. A fellow-competitor in his/her group.
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