Date of Application
| Membership Type |
PRIMARY APPLICANT INFORMATION |
| First Name | Middle Initial
| Last Name
|
Residence Street Address
| City
|
State
| Zip
| How long have you resided at present address?
|
Email Address (for Communications including Statements)
| Cell Phone Number
| Date of Birth
|
OCCUPATION |
Name of Firm, Corporation or Company
|
Nature of Business / Profession
| Position / Job Title
| Length of time at company?
|
Business Street Address
|
Business Phone Number
| Business Email Address (if different from above)
| |
STATEMENT DELIVERY METHOD MAIL EMAIL
If you selected MAIL, which mailing address do you prefer?
RESIDENCE BUSINESS |
SPOUSE / SPOUSE EQUIVALENT INFORMATION |
| First Name | Middle Initial
| Last Name
|
Email Address (for Communications including Statements)
| Cell Phone Number
| Date of Birth
|
OCCUPATION |
Name of Firm. Corporation or Company
|
Nature of Business / Profession
| Position / Job Title
| Length of time at company?
|
Business Street Address
|
Business Phone Number
| Business Email Address (if different from above)
| |
FAMILY INFORMATION |
Name of Children & Birthdates
|
Quick Family Bio for Member Posting
|
ADDITIONAL INFORMATION |
Name of Primary Banking Institution
| Banking Institution Address
|
Are you related to a current Member?
Yes No | If YES, name of current member and relationship?
|
PLEASE CHECK ALL ACTIVITIES YOU WOULD LIKE TO HEAR ABOUT VIA EMAIL UPDATES |
|
MEMBERSHIPS: PLEASE LIST ANY CLUBS OF WHICH YOU ARE A CURRENT MEMBER (Please Include City and state)
|
MEMBERSHIPS: PLEASE LIST ANY CLUBS OF WHICH YOU ARE A FORMER MEMBER (Please Include City and state)
|
HAVE YOU EVER BEEN REJECTED, EXPELLED OR DROPPED FROM MEMBERSHIP OF ANY CLUB? (If YES. please list the Club Nome and state the reason)
|
SPONSORS INFORMATIONENDORSEMENT: A Primary Member Sponsor is required. It must be a current Maketewah Member in good standing. |
Primary Sponsor Name (first and last)
| How many years have you known member?
|
Secondary Sponsor Name (first and last)
| How many years have you known member?
|
ACKNOWLEDGEMENT & SIGNATURE |
| Dues ore invoiced and payable monthly in advance and must be paid by the 20th of the month. By the signing of this application, on applicant, if accepted into membership, agrees that in case of termination of his/her membership, unless such termination is caused by death, he/she shall be obligated to pay o minimum of one year's dues and balance of initiation fee, if applicable. Member also agrees, for self and family, to observe the Rules and Regulations of the Club, either as they ore now in force, or as they may hereafter be adopted by the Boord of Directors. Pre-notification: Public low 91-508 requires that we furnish you this notice because we ore processing your application for membership at Maketewoh Country Club. A routine inquiry may be mode as to your eligibility for membership, including information as to character and general reputation. Additional information as to the nature and scope of this inquiry, if made, is available to you upon written request. |
Applicant Signature (type name below)
| Date
|
| |
