2020 Summer Membership Applications

2020 SUMMER MEMBER APPLICATION Lost City Golf Club

UNLIMITED GOLF AND UNLIMITED CARTS

NO F&B MINIMUMS

MAY 1 – OCT 31 2020

PERSONAL INFORMATION Name __________________________________________________________________________________________ Title

First

Middle Initial

Last

Nickname

Home Address __________________________________________________________________________________ Street

City

Home Phone Number _________________________

State

Zip Code

Mobile Phone Number _______________________________

Date of Birth ________________________________________ Email Address _______________________________________________________________________________________  Single

 Married

 Divorced

 Widowed

If married, please fill out the Spouse information below.

BUSINESS INFORMATION Nominee’s Occupation and/or Nature of Business or Profession ___________________________________  Retired Name of Company _________________________________________ Title _____________________________________ Business Address ________________________________________________________________________________ Street

City

State

Zip Code

Business Telephone Number ________________________________ Years in Present Employment __________________ Education Background ________________________________________________________________________________

SPOUSE PERSONAL INFORMATION Spouse Name ___________________________________________________________________ Title

First

Middle Initial

Last

____________ Nickname

Mobile Phone Number_________________________________ Date of Birth ____________________________________ Spouse’s Email Address _______________________________________________________________________________

Spouse’s Occupation and/or Nature of Business or Profession _________________________________________________ Name of Company _________________________________________ Title _____________________________________ Business Address ________________________________________________________________________________ Street

City

State

Zip Code

Business Telephone Number ________________________________ Years in Present Employment __________________ Education Background ________________________________________________________________________________

The 2020 Summer Season is from May 1st, 2020 to October 31st, 2020.

Summer Dues: Circle one Single: $ 2,500 Couple: $ 3,500

MEMBERSHIP AGREEMENT

The privileges and conduct of each member are governed by the Club’s By-laws, Policies and Rules, and Regulations, as they may be amended from time to time.

This includes the following: All debts incurred each month shall be paid by the 30th of the following month or all club privileges may be revoked and all fees forfeited for the remainder of the summer golf season.

I have read the conditions above and if accepted for membership, agree to abide by them.

_____________________________________________________________ Signature Date ________________________________________________