Name:

Member Type:

Golf Member Junior Member Ladies Golf Member PGA Member

Email Address:

Yeas of golf played:

Beginner 1-2 3-4 5-6 7-8 9-10 10+

Handicap:

0 1-5 6-10 11-15 16-20 21-25 26-30 31-35 36-40 41+

How many time per month do you hit balls?

Once 2-3 times 4-5 times 5-6 times 6-7 times 7-8 times More than 8 times

How much practice time do you devote to Short Game?

90% or more 80%-90% 70%-80% 60%-70% 50%-60% 40%-50% 30%-40% Less than 30%

Current Ball Flight

Straight Straight then Slices Straight then Hooks Right-to-Left Left-to-Right Straight to the Left Straight to the Right Left then Hooks Right then Slices

Desired Ball Flight:

Straight Right-to-Left Left-to-Right

Do you hit the ball...

High Trajectory Low Trajectory

Do you hit the ball...

Thin (hit on top of the ball) Fat (hit too far under the ball)

Describe a current shot when not hit it well:

Describe any medical conditions limiting your golf swing:

Web Address of any Video:

Question for Professional: