Advanced Golf Training and Instruction For Golfers Seeking High Performance at Australia's leading Golf Academy


Client Profile Form

Thank you for your interest in the Australian High Performance Golf Academy Training Programs.

Our goals are to help you in whatever way we can to achieve your dreams and desires.

Please answer ALL QUESTIONS, in a genuine and honest manner.

We will then asses your requirements and construct a training program to suit your requirements
First Name*   Last Name*  
Address
Suburb    State  Postcode     
Country Gender*   Age Range
Phone   Fax   Mobile
Email Address *
Confirm Email*
Occupation
Company   Position
How did you find out about us Please Specify Other

Explain briefly why you intend to enroll at the Australian High Performance Golf Academy

Approx Start Date at AHPGA   Month Year 

Approx Finish Date at AHPGA   Month Year 

Your Golf Background:
Are you a member of a golf club? If Yes, Name of Club
Do you have a CLUB handicap? If Yes,What is your CLUB handicap?
What is your best score EVER? Par    Club Name 
What is your best score Last 12 Months? Par    Club Name 
How often do you play 18 Holes in a month? Are you Left or Right Handed?
Do You Prefer to Play or Practice Golf? How often do you practice golf in a week?
What is the average length of your practice sessions? What % of your practice time is devoted to your?Long Game  Short Game   
Specifically what do you spend most of your practice time working on? Please Specify
Do you take golf lessons from a qualified PGA / LPGA golf instructor? If yes, how many golf lessons have you had in the last 12 months?
If you take lessons from a professional, specifically what have you been working on?
Have you improved your scoring average and / or handicap since the introduction of your lessons If no, why do you think this is the case?


Your Current Shot-making Ability: (Full-Swing)

On average how many Fairways do you hit in 18 holes? On average how many Greens do you hit in 18 holes?
On average how far do you carry your tee-shots through the air? Metres What is your average driving distance including carry and roll?    
See Below:

As per Diagram Above:
Indicate whether you think your driver flight is…  





As per Diagram, Left:

Indicate your most common shot shape with your driving club and fairway metals


Your Current Shot-making Ability: (Short-Swing)

As per Diagram Above:
When you miss a green with a short iron (8,9,W,SW)
do you have a tendency to miss.....

As per Diagram Above:
From just off the green what % of time do you get the ball onto the green and into the hole in 2 shots?

As per Diagram Above:
From in the bunker what % of time
do you get the ball onto the green with your first shot?

As per Diagram Above:
From in the bunker what % of time do you get the ball
onto the green and into the hole in 2 shots?

What % of putts do you make from the following distances? One Metre Putt: Two Metre Putt: Three Metre Putt:

As per Diagram Above:
When you miss short putts (Up to 2 metres)
do you have a tendency to miss.....


About Your Golf Clubs
What is the make (Brand) of your golf clubs? Are your golf clubs custom made for you?
Which club/s in your bag is your Least favourite? Which club/s in your bag is your Most favourite?
Do you think your clubs are [select]: Weight Shaft Flex Shaft Length Grip Thickness


Your Golf Goals and Objectives:
What in your opinion stops you from reaching your golf goals now?

List up to 5 important goals you would like to achieve with your golf over the next 12 months. These goals can be a combination of technical, tactical or a performance based nature. (Be specific)

1.

2.

3.

4.

5.

Of the goals chosen pick the 2 goals you would like to achieve in the next 6 months.

1.

2.

Explain briefly why you chose these goals over the others.

Goal (A)

To Be Completed By   Month Year 
As a way of reinforcing your commitment to the goals, please write your name here

Goal (B)

To Be Completed By   Month Year 
Your Name

What will you do to ensure you achieve your 2 chosen goals. Specifically what actions and resources are needed for you to follow through.
Of the two goals chosen which one do you want to improve first?

Medical Background:

Do you have Medical Injuries we should know about?:

It's important that we know that you are Physically Ready to attend our Golf School program.
Injuries may restrict your activities, so you may need to seek professional advice from a qualified doctor or physical therapist before attending one of our programs.

Please advise us of any injuries (Past or Present) as per the diagram below:
For multiple selections press"Control" or> "Ctrl" button on your keyboard:

Please provide details of the injuries identified above
including whether it's a recent injury or you have had it for some time.

Also state whether it's a joint injury or muscular in nature
and whether your having regular treatments.

In the event of an emergency please supply us with
the name of your Next of Kin[Spouse, Relative, etc].

Next of Kin:   Contact Number:

Is there any other information that you would like to supply,
or questions that you would like to ask?:

We respect your privacy and confidentiality.(c)AHPGA 2006


PLEASE ENSURE ALL FIELDS ARE COMPLETED BEFORE SUBMITTING THIS FORM

If after submitting this form, a new "Blank Window" opens, then the form has not been completed, and therefore not submitted. In which case you should go back and complete all the required fields and try again