A. Membership
Information
Membership desired:
Resident
Associate
Junior
House
B. Nominee Information
Nominee Name:
Residence:
Home Phone:
Years at this residence:
Nominee Date of Birth:
(applies to Junior Membership
only)
Place of birth:
High School:
College:
Graduate School:
B1. Spouse
Information
Spouse's Full Name:
(please include maiden name)
Spouse Date of Birth:
(applies to Junior Membership
only)
Spouse Place of Birth:
Spouse High School:
Spouse College:
Spouse Graduate School:
B2. Child
Information
Child Name
Date of Birth
Children's Information:
C. Nominee
Business Information
Occupation/Title:
Employer:
Type of Business:
Business Address:
Business Phone:
Business Fax:
Email Address:
Date/length of employment:
Previous Employer's:
(please include dates)
C1. Spouse
Business Information
Occupation/Title:
Employer:
Type of Business:
Business Address:
Business Phone:
Business Fax:
Email Address:
Date/length of employment:
Previous Employer's:
(please include dates)
D. Other Club Affiliations -
Nominee and/or Spouse Information
Please list affiliations with
other clubs of which you (and/or your spouse)
are now or have been a member. Indicate
the address and period of membership in each:
Have you ever applied for
membership or been a member of any other club?
Yes
No
If yes, please list club(s) name,
city and state:
Please list any other civic
and/or social organizations to which you belong:
Why do you (and your family) want
to join Orange Lawn Tennis Club?
Please list ALL Club
acquaintances:
Please be specific
(please include names, length of
acquaintances, whether relationship is business,
social, tennis or other)
E.
Nominee Authorization to Disclose & Release
Information
I hereby
authorize the disclosure and release of
information to Orange Lawn Tennis Club for the
purposes of investigating my character, general
reputation, personal characteristics, mode of
living, reputation and financial condition.
I would prefer to be called at:
Home
Business
No
Preference
I certify to the
best of my knowledge, the foregoing information
is correct. I understand that any
misrepresentation shall be cause for denial of
further consideration.
If elected to
membership at Orange Lawn Tennis Club, I agree
to abide by the Constitutions, Bylaws, Rules,
Regulations and Policies of the Club as set
forth by the membership and the Board of
Trustees.
By typing your
name below, you certify that you are the person
for whom this application is being submitted,
and that all the information entered is accurate
to the best of your knowledge. You may
still be asked to sign this document in person
at a later date.
Please type your full name to
indicate your signature on this application
document.
