Application / Renewal Form

Please complete the appropriate areas:

Personal Details:
First Name: Surname:
Company Name: GP Membership Number:
Street Address: Suburb:
Postcode: State:
Home Phone: Work Phone:
Mobile: Email:

Please select your membership type:

Golfers PIP plus Premium(1 year Membership) - $79

Golfers PIP plus Premium(2 years Membership) - $129 (save $29)

Golfers PIP plus Handicap(1 Year Handicap Card) - $189 (Including All premium benefits)

I wish to apply for a new or renewed AGU Handicap. My signed scorecards are attached (5 for men /3 for women ) all noted with my markers current Golflink number. I understand that my handicap will be managed by a Golfers PIP plus selected course in my state.

I am unable to attach and will mail originals to PO Box 622 Carnegie Victoria 3163

Golfers PIP plus Corporate(1 Year Corporate) - $299 (Including all Premium benefits for 6 memberships)

Payment details:

Master Card          Visa

Name On Card:

Card number:  

Expiry Date:        CVV (on reverse of card)

Yes I understand and agree!

Please enrol/renew my Golfers PIP plus membership at the nominated fee. I also agree that to ensure I receive ongoing, uninterrupted membership to my Golfers PIP plus membership and all associated covers , that my nominated account will be debited the applicable membership fee on renewal each renewal period. I further understand that if I choose to not continue my membership on renewal, that I have 30 days from the renewal date to cancel my membership and receive a full refund for that renewal only. I also confirm that I have read the PIP Product Disclosure document and agree and understand all the terms specified in that document.