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MGA NHS No. Promocode Full Name MGA NHS No. PromoCode If you do not remember your NHS No., kindly present your existing Golf Club membership card and we will check your NHS No. to validate later. [For office use: kindly fill in the Golf Club membership card No. & Name of Club] Full Name (as per MyKad) Name printed for GoGolf card (21 char) Gender Male Female Birth Date (dd/mm/yyyy) - - Nationality MALAYSIAN MyKad - - Race Malay Chinese Indian Others Mobile No. - Home Tel No. - Email Address MailinG Address City State Postcode Country Payment Method: Payment by Credit Card / Prepaid Card Payment by Cash Payment by Cheque Cheques made payable to “PERSATUAN GOLF MALAYSIA” Maybank 514543136586 Money GoGolf VISA Prepaid card (Please select appropriate) Card Options Package RRP 6% GST Total Select 1. GoGolf package for Juniors (18 years and MYR 200.00 MYR 12.00 MYR 212.00 below) In accordance with the provisions of the Personal Data Protection Act 2012, I hereby agree and consent that the Malaysian Golf Association (“MGA”), Finexus Cards Sdn Bhd ("FINEXUS"), MST Golf Sdn Bhd ("MSTGOLF"), Bank Simpanan Nasional ("BSN") and Zurich Insurance Malaysia Berhad ("ZURICH”), (Individually referred to as the “Party” and collectively as the "Parties"); may collect, use, disclose and process my personal information provided by me to the Party or the Parties, for one or more of the purposes as stated in MGA’s Terms and Conditions available at www.gogolf.my, for the following purposes including but not limited to the following: a. To process my application and provide me with services and products offered by the Party or the Parties or for services and products offered by other third party Vendors through the Party or the Parties; c. To permit and consent the Party or the Parties and or its affiliates, subsidiaries, branch officers, business partners, related corporations and third party service providers/agents (including and without limitation, insurance companies, valuation firms, lawyers/law firms) of the Party or Parties, to disclose my personal information to the Party or Parties for the purpose of processing my application; and d. To send me marketing, advertising and promotional information (“MarketinG MessaGes”) about other products/services that the Party or Parties and or its affiliates, business partners, related corporations and third party service providers/agents may be offering or which MGA believes may be of interest or benefit to me (“MarketinG Purpose”). Full Name Signature Date FOR OFFICE USE ONLY Paid by Credit Card Paid by Cheque Paid by Cash Signature (Person-in-charge) Alternate GoGolf Preferred No. Name (Person-in-charge) Date Form Version 1.7 General – 1st March 2017 LIST OF GOGOLF MEMBER CLUBS: • PONDEROSA GOLF & COUNTRY CLUB • CINTA SAYANG GOLF & COUNTRY RESORT • AUSTIN HEIGHTS G&C R • KULIM GOLF & COUNTRY RESORT SDN BHD • STARHILL GOLF RESORT BERHAD • KELAB KEDAH DARULAMAN DIRAJA • PALM RESORT GOLF & COUNTRY CLUB • DARULAMAN GOLF & COUNTRY CLUB • DAIMAN 18 JOHOR BAHRU • BLACK FOREST GOLF & COUNTRY CLUB • PALM VILLA GOLF & COUNTRY RESORT • KELAB GOLF PUTRA • KLUANG COUNTRY CLUB • BUKIT JAWI GOLF RESORT BHD • PERMAS JAYA GOLF • PENANG GOLF RESORT BHD • AYER KEROH GOLF & COUNTRY CLUB • CLEARWATER SANCTUARY GR • TIARA MELAKA GCC • TELUK INTAN GCC • BUKIT BERUNTUNG G & CC • KELAB GOLF SAMUDERA • MONTEREZ • KELAB GOLF KINTA • SRI SELANGOR • KENINGAU GOLF & COUNTRY CLUB • DANAU GOLF CLUB • SHAN – SHUI GOLF & COUNTRY RESORT BERHAD • KUNDANG LAKES COUNTRY CLUB • TAMBUNAN GOLF CLUB • KELAB GOLF PERKHIMATAN AWAM (KGPA) • DAMAI GC • KELAB SRI MORIB • EASTWOOD VALLEY GOLF & COUNTRY CLUB • LEMBAH BERINGIN GOLF CLUB • SAMARAHAN COUNTRY CLUB • KELAB RAHMAN PUTRA MALAYSIA • GREEN ACRES GOLF & COUNTRY RESORT • PORT KLANG RESORT GOLF • HARVARD GOLF RESORT (JERAI) BHD .
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