I wish to apply for a: Certificate MembershipNon-Equity MembershipJunior Non-Equity Membership (age 30 or younger)Tennis MembershipCorporate MembershipPool Social MembershipClubhouse Social PERSONAL INFORMATION Applicant Name First Last Applicant Birth Date Applicant Mobile Number Applicant E-mail Address Spouse Name First Last Spouse Birth Date Spouse Mobile Number Spouse E-mail Address Residence Address Street Address Address Line 2 City State / Province / Region Postal / Zip Code Names and Birth Dates of children (under 23, unmarried) Name First Last Birth Date Name First Last Birth Date Name First Last Birth Date Name First Last Birth Date Name First Last Birth Date Name First Last Birth Date Name First Last Birth Date Name First Last Birth Date BUSINESS INFORMATION/ APPLICANT Name of Employer Position How long in this business (yrs) Business Address Street Address Address Line 2 City State / Province Postal / Zip Code Phone BUSINESS INFORMATION/ SPOUSE Name of Employer Position How long in this business (yrs) Business Address Street Address Address Line 2 City State / Province Postal / Zip Code Phone OTHER INFORMATION Please tell us what facilities are of primary interest to you and your family at the club. Please send statements to: E-mail AddressHome AddressBusiness AddressAlternal AddressOther Destination Email Address Destination Address Street Address Address Line 2 City State / Province / Region Postal / Zip Code Please explain: Sponsor Name Full Name Amenities I would like to sign up for: Men's Locker - ($90 anually)Women's Locker - ($90 anually)Club Storage - ($140 each set anually)Electronic Fund Transfer - (No charge)Annual Golf Cart Pass - ($650 plus tax anually)Men’s Association - ($80 anually)Men’s Handicap - ($37 anually)Women’s Association - ($25 anually)Ladies Handicap - ($37 anually) Range Pass: (See rate sheet) NoneIndividualJuniorSeniorCouplesFamily Bill my dues: AnnuallySemi-annuallyQuarterlyMonthly I agree to abide by the rules and bylaws of the club.(The bylaws can be viewed by clicking here or you can request a copy from the office.)