USPTA personal Web site and facility site questionnaire

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1 USPTA personal Web site and facility site questionnaire Once you become a USPTA-certified professional, we encourage you to reserve your free site at by filling out the information below. We then will activate your domain name and address, and notify you when your site is available. Please type or neatly print your biographical information, which we will use to create your home page. You may fill out all of it, or only those parts that you would like included on your site. You may attach additional information, including a resume, to your signed questionnaire. Please mail a color photo (head-and-shoulders shot) of yourself to USPTA, c/o Julie Myers, 3535 Briarpark Drive, Suite One, Houston, TX For more information, call (800) USPTA-4U ( ) or (713) 97-USPTA ( ) or fax to (713) First name: Last name: MI: Name you go by (nickname) if different from above: Member No: Do you want a facility site (to promote your club, center or school)? If so, please see Facility Site Questionnaire. Please provide three (3) choices of a name or combination of letters and numbers that you would like to use as your site name: 1..usptapro.com 2..usptapro.com 3..usptapro.com address: Phone numbers (not for publication): (h) (w) (fax) Home address (not for publication) City: State: ZIP: Country: Place of employment (as tennis pro): City: State: ZIP: Title: Any other current place of employment (as tennis pro): City: State: ZIP: Title: Previous places of employment:

2 Do you (or did you) work outside the tennis industry? If so, where, in what position and for how long? Does this non-tennis employment complement your performance as a tennis pro (or vice versa)? Education (please include degrees, and name and location of colleges or universities): USPTA offices you have held and honors received (please indicate if past or current office): Other organizations (affiliations and honors): Playing experience: When and why did you become a tennis pro?

3 What do you enjoy most about the profession and what are your areas of expertise? What do you consider your greatest accomplishment (1) as a tennis pro and (2) outside the tennis industry? Future goals: Additional information (family, other interests, personal or professional highlights): Personal Web site agreement: I understand that USPTA owns and retains all rights to develop my site in accordance with consistent standards. I give USPTA permission to use my name, written information and photograph(s) in this manner. I also will not hold USPTA responsible if, for any reason, it chooses to discontinue this site at some time in the future. Signature: Date:

4 Facility site questionnaire (Promote your facility with a free site at If you want a facility site to complement your home page, please type or neatly print and return this form with either a color brochure or four to six color photos featuring your club, center or school. We need pictures of the facility (courts) and tennis activities. Also include a logo, if available. You do not need to fill out this form if your brochure or personal Web site questionnaire contains the requested information. Please send all materials to USPTA, c/o Julie Myers, 3535 Briarpark Drive, Suite One, Houston TX For information, call (800) USPTA-4U ( ) or (713) 97- USPTA ( ) or fax to (713) First name: Last name: MI: Type of facility (private, public or educational): Name of facility: Facility address: City: State: ZIP: Country: Facility phone No.: Fax: Your title: Responsibilities: How long have you been at this facility and have you held any other positions there? Number and types of courts: Other facilities (such as pro shop, clubhouse, fitness center, swimming pool, etc.):

5 Types of programs and services offered (lessons, leagues, tournaments, junior development, racquet stringing, etc.): Features (such as aesthetic appeal, achievements, history, service, philosophy, etc.) that make your facility or program outstanding:

KINGS CREEK COUNTRY CLUB, INC. APPLICATION FOR MEMBERSHIP Spring Membership Drive April 1, 2011 June 30, 2011

KINGS CREEK COUNTRY CLUB, INC. APPLICATION FOR MEMBERSHIP Spring Membership Drive April 1, 2011 June 30, 2011 Date of Application Date of receipt to KCCC Category of membership desired: Please check one: