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Name:   Sex:Male Female    Age:  

Address:

City:     State or Province: 

Zip or Postal Code:       Country:

Telephone   Fax:    Email:

Height:    Weight:    Wrist to Floor:     Glove Size:

I am and play golf

Do you have any physical limitations or restrictions? Yes   No

If so, please describe:

I have played golf for years, and play rounds per year.

My handicap index is My average score on a regulation course is

I  hit fairways and greens per round, and take putts

The best part of my game is  and the worst is

Present Driver:  Make: Model:   Shaft:

                         Flex:  

Present Fairway Woods: Make: Model:   Shaft:

                        Flex:

Present Irons:    Make:   Model: Shaft:

                        Flex:    

On average, I hit my driver yards in the air.

On average, I hit my 5 iron yards in the air.

Typically, my driver trajectory is and the path is

My fairway wood trajectory is and the path is

My long iron trajectory is and the path is

My mid-iron trajectory is and the path is

My short iron trajectory is and the path is

My favorite club is my and my least favorite is my

I am interested in

The one most important benefit I expect from my new clubs is

Please make any comments or suggestions that you feel may be helpful: