BIRCHWOOD COUNTRY CLUB APPLICATION FORM by TQgNXU

VIEWS: 2 PAGES: 2

									                                            POOL AND SOCIAL 2012
      Annual Fee $600.00                                                       Member Acct #________
                                                                               Date Application & Payment
                                                                               Received: ________________


                BIRCHWOOD COUNTRY CLUB APPLICATION FORM

                        NAME_____________________________________________________________

                       ADDRESS___________________________________________________________

                        E-MAIL ADDRESS___________________________________________________

                        CITY____________________________________, COUNTY_________________

                        STATE____________, ZIP_____________, PHONE________________________


                                                        DATE OF BIRTH _________________________

I _________________________________________________, am requesting membership into Birchwood Park, Inc. otherwise
known as Birchwood Country Club as a Pool and Social Member. If accepted, I will conform to all rules and regulations as dictated
by the By-Laws and the Board of Directors of Birchwood Country Club.
                                                                   DATE_____________________________

APPLICANT’S SPONSOR_____________________________________________ (MEMBER OF BWCC)

            PRINT NAME_____________________________________________

CO-SPONSORED BY________________________________________________ (SIGN & PRINT NAME)

CO-SPONSORED BY________________________________________________ (SIGN & PRINT NAME) *******

                                                   PAYMENT METHOD

                       A) PAYMENT OF $600.00 IN FULL IS DUE WITH APPLICATION



     OTHER FACTS OF INTEREST REGARDING APPLICATION AND MEMBERSHIP

A)   Applicant or sponsor must attend the first Board meeting following submitted application.
B)   Application for membership is voted upon only at regular meetings of the Board of Directors.
C)   The application is posted for membership for 15 days before full membership privileges are given.
D)   Membership privileges are limited to the member, spouse and dependent children. (See By-laws Governing
     Restrictions on Children.)
E) By-Laws, Page 7, Section 12: Pool and Social Membership – Full use of the pool, tennis courts and lounge for one
     year upon paying $600.00 and approval of the Board. Dining minimum of $10 applies to the months of June,
     July and August.
                                             MEMBER
                                          DATA SHEET


1. NAME____________________________________________________________________

2. DATE OF BIRTH_________________________DATE ELECTED___________________

3. HOME ADDRESS___________________________________________________________

4. E-MAIL ADDRESS__________________________________________________________

5. BUSINESS TELEPHONE_____________________________________________________

6. MOBILE OR CELL______________________________________________________________________

7. SPOUSE NAME_____________________________________________________________

8. DEPENDENT CHILDREN/BIRTHDATES_______________________________________

                                          _______________________________________

                                          _______________________________________

                                          _______________________________________

9. EMERGENCY CONTACT____________________________________________________

10. CONTACT TELEPHONE NUMBER___________________________________________

11. JOINED BIRCHWOOD ______________________________________________________

12. RESIGNED MTH/YR________________________________________________________

13. REJOINED MTH/YR________________________________________________________

14. DUES DRAFTED___________________________________________________________

15. FAX NUMBER_____________________________________________________________

16. OCCUPATION_____________________________________________________________

								
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