Experience Spotswood Country Club

TYPE OF DESIRED MEMBERSHIP

o Premier

o Full (Ages 40 & Over)

o Full (Ages 30-39)

o Full (Ages 29 & Under)

o Social

o Pool

o Clubhouse

o Non-Resident

APPLICANT INFORMATION Name Title First

MI

Last

Home Address

Street

City

State

Zip Code

Billing Address (if different)

Street

City

State

Zip Code

Primary Email Address

Mobile Telephone Number

Date of Birth

Occupation and/or Nature of Business or Profession

o Retired

Name of Company

Title

Business Email Address

Business Phone Number

o Single

o Married

o Significant Other

o Widowed

Anniversary Date

SPOUSE/SIGNIFICANT OTHER INFORMATION Name Title First MI

Last

Primary Email Address

Mobile Telephone Number

Date of Birth

Occupation and/or Nature of Business or Profession

o Retired

Name of Company

Title

Business Email Address

Business Phone Number

CLUB CORRESPONDENCE Please send any and all official correspondence to the following addresses:

o Primary Email

o Business Email

o Spouse/SO Email

o Home Address

o Billing Address

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