Pass Application

Corporate Company Name: __________________________________________
Address: _______________________________________________ _______________________________________________________
City: __________________________________________
State: ______________________	Zip: _____________
Phone: _____________________	Fax: _____________

I am applying for the following type of pass:
Platinum: _______________		Platinum Plus: _______________
Corporate Company Designees:
______________________		______________________
______________________		______________________

	# of Participants
Platinum Range Plan($150.00):	_____________________
Names:_______________________________________________
Golf Handicapping Service($20.00):	_____________________
Names:_______________________________________________
Locker Storage($75.00):	_____________________
Names:_______________________________________________
Club Storage($75.00):	_____________________
Names:_______________________________________________

Method of payment:
Cash__ Check__ Credit Card__
Credit Card #:_____________________________________
MasterCard__ Visa__ Discover__ AMEX__
Expiration Date:___________________________________
Cardholder's Name:_______________________________
Cardholder's Signature:____________________________

Cancellations of passes / Rights of pass holders

Old Works reserves the right at any time to cancel any seasonal passes issued to any applicant. These passes do not include any share, interest or ownership of any kind in Old Works. I have read and agree to abide by the Old Works Golf course rules and regulations, as they now exist or may hereater be amended.

Name:________________________________________

Signature:________________________________________

Spouse Signature:_________________________________

Date:____________________________________________

Please remit to the Golf Shop or mail to:
Old Works Golf Course
General Manager
P.O. Box 100
Anaconda, MT 59715