2024 Women's State Medallion Club Team Order Form

2024 State Medallion Order Form

Complete the form below to order your club's medallions for 2024 qualifiers. 2024 Update Due to AZ GOLF rebrand: Medallions will be mailed to those clubs that have requested them in the summer for Northern Region clubs and in the fall for Central and Southern Region clubs. Orders received after the initial mailing will be filled as they are received.
Club Name*
Women's Club Rep Name*

First NameLast Name
E-mail*
Phone Number:

Area CodePhone Number
Address for which you would like medallions to be mailed:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Number of Qualifying Teams

The number of qualifying teams per Club is determined by the number of active AGA members on the roster with a GHIN Handicap as of September 1 of the qualifying year the winners are determined. Clubs may choose to register additional teams based on their total membership listed below. (A 9-hole club administered within an 18-hole club’s print group qualifies as a 9-hole club).

For 9-hole clubs:
75 members = 1 team
76-125 members = 2 teams
126 or more members = 3 teams

For 18-hole clubs:
350 members = 1 team
351-700 members = 2 teams
701 or more members = 3 teams
How many teams will your club qualify based on the information above?*

One TeamTwo TeamsThree Teams
Note or Question for AGA Staff:
Should be Empty:

2024 State Medallion Order Form