MEMBERSHIPS APPLICATION

PINETOP COUNTRY CLUB

I hereby apply for Membership in the Pinetop Country Club, Pinetop, Arizona and submit the following information regarding:

Name

Birthplace

Birth Date

Residence Address

How long?

City

State

Zip

Home Telephone

Business Name

City/State

Zip

Business Telephone

Local Address

City/State

Zip

Local Telephone

Other Phone

Average Length of Stay in Pinetop Area

Wife's Name

Birthplace and Date

Names and Ages of Children

Occupation (Firm and Position)
(Please complete even if you are presently retired)

Nature of Business

No. of Years with Firm

Banking Connections

Membership in Other Clubs or Societies Please provide name of organization, city and state

Do you play golf?

Does your wife play golf?

Do your children play golf?

Other Interests

Have you ever been denied membership or dropped from members in any club? If so, give club and details

Do you have relatives who are or have been members at Pinetop Country Club? List names

List below 6 members of Pinetop Country Club with whom you are well acquainted

Name	Address	City/State	Zip	Club
1.
2.
3.
4.
5.
6.

If at least 6 members are not listed above, please give 4 references preferably members of clubs which candidate belogs or has belonged

Name	Address	City/State	Zip	Club
1.
2.
3.
4.

This proposal is submitted with the knowledge that the number of members in the Pinetop Country Club is restricted by its by-laws and that elections to membership is by approval of the board of directors.

The membership fee shall accompany this application and will be deposited upon notification of election to membership.

By submitting this form, you claim that all information is true and accurate to the best of your knowledge. Please stop by the Pinetop Country Club office to submit payment for your application and sign a membership agreement form.

PINE TOP COUNTRY CLUB - Pinetop, Arizona

MEMBERSHIPS APPLICATION

PINETOP COUNTRY CLUB