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 ________________________________________________