Membership Form

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Type of Membership

Family Equity Partner MembershipIndividual Non-Equity MembershipYoung Executive Equity Partner Membership

Entity Member's First Name

Entity Member's Middle Name

Entity Member's Last Name

Date of Birth

Social Security/ National Insurance Number

Unique Tax Reference Number (UK only)

Spouse's First Name

Spouse's Middle Name

Spouse's Last Name

Country of Residence

Full Address

0 /

Billing Address (If Different From Above)

0 /

Mobile Telephone Number

Home Telephone Number

Spouse's Telephone Number

Applicants Email Address

Applicant Handicap

Spouse's Email Address

Spouse's Handicap

Unmarried Children Under The Age of 26

Name	Birth Date	Charging Privileges Yes/No
			×

(1)

Business

Company Name

Title

Business Address

0 /

Business Telephone Number

Years With Present Company

Retired?

YesNo

Year of Retirement

Spouse's Company Name

Spouse's Title

Spouse's Business Address

0 /

Spouse Business Telephone Number

Spouse Years With Present Company

Banking Information

Name of Institution

Full Bank Address

0 /

Contact Person

Bank Telephone

Please List All Active Club Memberships

Active Club Memberships

Name of Golf Club	Year of Acceptance	Type of Membership	Full Address	Contact Person	Contact Person Telephone	Contact Person Email
							×

(1)

Have you ever been suspended or expelled from a membership club?

YesNo

Please add more information

0 /

Proposing Members

Proposing Member One's Name

Proposing Member One's Telephone

Proposing Member One's Address

0 /

Proposing Member One's Email

Proposing Member Two's Name

Proposing Member Two's Telephone

Proposing Member Two's Address

0 /

Proposing Member Two's Email

Membership Termination By Death or Divorce

In the event of the death of the membership holder, this membership shall be transferred to:

My spouse
My Children.

In the event of divorce this membership shall remain with the entity member listed herein, unless stated otherwise within the divorce decree.

The undersigned hereby submits an application for membership in The Renaissance Club at Archerfield.

Upon signing this Membership Application. I authorise the disclosure and release of information requested by the club for investigating my qualifications for membership, including without limitation my credit history.

Signed - Enter Your Full Name

Signed Date