Name:
Number of years played:
Address:
Address 2:
City/State:
Email Address:
Phone:
Social Security Number:   DOB:
Business/Profession : Title
Business Address: Phone:

If family membership:
Spouse's name: Social Security Number:
Number of years played:

List children under 22, ages and wether they play golf.

List membership in other clubs and areas of participation. (Include dates joined and/or terminated, committees, offices held, ect.)

List names of any club members known.

Which of the club activities are of interest:

I have been involved in the following volunteer activities:
Garden Club: Arts & Crafts: Photo: Hospice: Fund Raising:
Library Volunteer: Hospital Volunteer: Other:

Please furnish the following refrences and include complete addresses for all

Two Business Associates
Name: Title:
Full Address:

Name: Title:
Full Address:

Two Personal Refrences
Name: Title:
Full Address:

Name: Title:
Full Address:

Two Credit Refrences
Account Name: Account #:
Full Address:

Account Name: Account #:
Full Address:

I understand that the Board of Governors shall make the ultimate determination concerning my acceptance for membership or rejection of my membership application. I further aggree to make no claim against the Board of Legacy Golf and Tennis Club relating to and arbitrary rejection of my membership application.

I also understand should my application for membership be rejected that no reason for rejection shall be stated in any Club Representative's response.

*** Members' previleges shall be exercised in accordance with the By-laws, the Articles of Incorporation and General Club Rules of the Club. All charges incurred during the month are due and payable within ten (10) days of recieving your statement. If payment has not been recieved by the last day of any given month, a 1.5% finance charge will be charged to your 30-day balance ***

Initial here signifying that the responses provided
is true to the best of your knowlege and that you agree to the terms above.