Request Information on Golf Instruction

Yes, I am interested in information on golf instruction at Purdue. Please have one of your golf professionals contact me.
I want to Improve My Golf Game!
Personal Information:
*First Name:
*Last Name:
  Gender:
*Email Type:
 Personal  Business
*Email:
Address Information:
*Address Type:
 Business Address  Seasonal Residence  Home Address
*Street 1:
  Street 2:
*City:
*State / Province:
*Zip / Postal Code:
 
*Country (Addr):
Phone Number Information:
*Phone Number Type(s):
 Primary Business Number  Cellular Number  Residential Number
*Area Code:
*Phone Number:
  Extension:
*Country (Phone):
Purdue Golfer Profile:
  Date of Birth:  Calendar Lookup     Clear Field
*Please send me more information on:
 Season Passes  Golf Leagues
 Couples Events  Family Events
 Open to Public Tournaments  Football Game Day Events
 Lessons  Clinics
 Junior Golf  Golf Equipment
 Demo Days  Club Fitting
 Clothing Sales  None Of The Above
*How many times do you typically play per month:
*How much do you typically pay for a round of golf:
*Are you presently a member at another club:
  If yes, which one:
*How often do you play at our club:
*Which days of the week do you like to play golf:
 Monday  Tuesday
 Wednesday  Thursday
 Friday  Saturday
 Sunday  
*When do you typically play:
 Weekdays AM  Weekdays PM
 Weekends AM  Weekends PM
 Various Times  N/A
*Which area courses do you play:
 Ackerman Hills  Kampen Course
 Coyote Crossing  Battle Ground
 Lafayette Elks  The Ravines
 Lafayette City  Harrison Hills
 None of these  
*Please select any that apply to you:
 Purdue Student  Purdue Staff/Faculty
 John Purdue Club Member  Purdue Alumni Association Member
 None of the above  
  Who referred you to this site:
Info:
*What types of programs are you
interested in receiving information on:
 Private Lessons  Group Lessons
 Video Swing Analysis  Clinics
 Club Fittings  Club Repair
 Junior Golf  
Comments:
 
*By submitting this form, you are agreeing to receive future information from this organization and our partners.
Thank you for your interest in golf instruction at the Birck Boilermaker Golf Complex and for completing our survey.  A member of our staff will contact you in the near future.