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please print and fax application to (843) 686-2033.
Contact Information
Prefix
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Dr.
Mr.
Mrs.
Miss
First Name
Middle Name/Initial
Last Name
Suffix
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Jr.
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II
III
IV
Preferred Name/Nickname
Mailing Address
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Address Line 3
City
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Country
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Canada
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USA
Work Phone
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Fax
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Please select the phone number that you would like to have listed in the Membership Directory:
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Work Phone
Home Phone
Cellular/Mobile Phone
Email
Website
Personal Information
Gender
Female
Male
Race/Ethnicity (optional)
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African American
Asian
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Hispanic
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Other
Date of Birth
NTRP Rating
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2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
What is my NTRP Rating?
What organizations to you belong to?
(select all that apply)
ATA
USPTA
ATP/WTA
USRSA
ITA
USTA
Experience/Employment Information
Total Years of Teaching/Coaching Experience
Part Time (less than 20 hours per week)
Full Time (more than 20 hours per week)
Playing Experience
High School
College
Employment Status
-Select One-
Full Time
Part Time
Seasonal
Independent Contractor
Not Currently Teaching
Facility where you teach/coach
Position/Title
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Director of Tennis
Head Professional
Manager
Owner
Staff Professional
Athletic Director
Assistant Athletic Director
Assistant Men's Coach
Assistant Women's Coach
Assistant Men's/Women's Coach
Head Men's Coach
Head Women's Coach
Head Men's/Women's Coach
Other
Facility Address
Address Line 2
Address Line 3
City
State/Province
Zip/Postal Code
Country
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Canada
Guam
Northern Mariana Islands
Palau
Puerto Rico
US Virgin Islands
USA
Phone
Email
Website
Is there a pro shop on site?
Yes
No
Other Experience
Referral
If you were referred to PTR by one or more people, please list their name(s):
Why did you decide to join PTR?
Workshop Registration
To reserve a space in a PTR workshop, select a date and location from the
workshop schedule
and enter the information in the space provided below. You will need to add the workshop fee of $95 on the next page to ensure registration.
I will select a workshop date/location at a later time by contact PTR Headquarters or
registering online
.
Code of Ethics
By checking this box I acknowledge that I have reviewed the PTR Code of Ethics and agree to abide by the rules of conduct as set forth. Please accept my application.
Payment Method
I intend to pay online with credit card.
I intend to pay by mail mail with check/money order.
I intend to pay by phone with credit card.
Thank you for applying to become a new PTR member! Disclaimer: online registration is not valid until payment is received by PTR International Headquarters.
