By signing up , I hereby declare that I have read and agreed with thestipulated terms and conditions provided herein.

Applicant’s SignatureDate:

For more info, Tel (603) 8925 1010 Fax (603) 8925 5326www.danaugolf.com

Owned by Kelab Rekreasi Universiti Kebangsaan Malaysia (KRUKM).Managed by Saujana Scape & Greens Sdn Bhd (SSG)

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Application Form

1. Card holder details

Name

Name

Name to appear on card

Date of birth NRIC / Passport No.

Date of birth NRIC / Passport No.

Address

Postcode City State

Tel no. (Mobile) Tel no. (Home / Office)

Tel no. (Mobile) Tel no. (Home / Office)

E-mail

2. Spouse Details

3. Children Details

4. Payment Method

* Select one.

Name Age Sex

Name Age Sex

Name Age Sex

Name Age Sex

* All information are compulsory.

Name Age Sex

Credit Cards*: VISA / MASTER Card No. Expiry

Cash Bank draft or Cheque No. (made payable to Saujana Scape and Greens Sdn. Bhd.)

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n up

Now

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with Danau Golf Cub MembershipEnjoy more privileges

Unlimited access to golfing facilities (subject to flight availability).

Free access to all clubhouse facilities including swimming pool, karaoke,

snooker, gymnasium and more (advance booking is required).

Membership privileges are extended to spouse and children

below 18 years old.

Enjoy members’ buggy rate for golfing.

Get access to all reciprocal and affiliation clubs .

Handicap maintenance (terms and conditions apply).

Discount privileges at food and beverage outlet.

Member’s rate for driving range balls.

Issuance of membership card.

IndividualMembershipRM4000Limited to 400new memberships only

Danau Golf Club, Universiti Kebangsaan Malaysia, 43600 UKM, Bangi, Selangor Darul Ehsan