Page 1 of 4 We strongly recommend using Internet Explorer 5+ or Netscape 6+ in order to ensure the most user-friendly experience possible when signing up for LeaderBoard. Simply fill out the required fields (*) below to begin enjoying the benefits of the Golf Town LeaderBoard Membership Privileges Program. Salutation (*)    -- Choose one -- Mr. Mrs. Ms. Miss Dr. First Name (*)    Last Name (*)    Address 1 (*)    (no commas) Apt.#    Address 2    City (*)    Province (*)    -- Choose one -- AB BC MB NB NF NS NT NU ON PE PQ SK YT Postal Code (*)      Home Phone   ()  -   e.g. (555) 765 - 4321 Cell Phone   ()  -   e.g. (555) 765 - 4321 Email Address (*)    Please enter a valid email address and confirm below. Retype your email address (*)    Please indicate your birthday    Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31    Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec    Year 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 Annual Household Income    -- Choose One -- Less than $25 000 $25 000 to $49 999 $50 000 to $74 999 $75 000 to $99 999 $100 000 to $124 999 $125 000 to $149 999 $150 000 + Golf Town Primarily Shopped At:    -- Please select -- Aurora, ON Barrie, ON Boisbriand, QC Brampton, ON Burlington, ON Calgary East, AB Calgary North, AB Calgary South, AB Candiac, QC Coquitlam, BC Dartmouth, NS eCommerce Edmonton North, AB Edmonton South, AB Edmonton West, AB Etobicoke, ON Gatineau, QC Hamilton, ON Kelowna, BC Kingston, ON Kitchener, ON Langley, BC Laval East, QC Laval, QC London, ON Markham East, ON Markham, ON Milton, ON Mississauga, ON Mississauga-Heartland, ON Montreal, QC Ottawa East, ON Ottawa, ON Pointe-Claire, QC Quebec City, QC Red Deer, AB Regina, SK Richmond, BC Saskatoon, SK Scarborough, ON St. Catharines, ON St-Hubert, QC St-Leonard, QC Sudbury, ON Surrey South, BC Surrey, BC Toronto, ON Toronto-Laird, ON Vancouver North, BC Vaudreuil, QC Victoria, BC Whitby, ON Windsor, ON Winnipeg South, MB Winnipeg, MB Woodbridge, ON      What other sports and recreational activities do you participate in? Baseball Basketball Boating Curling Cycling Fishing Fitness Program Football Health/Fitness Club Hockey Jogging Lacrosse Motorcycling Soccer Swimming Tennis Skiing or Snowboarding Weight Training