Membership Application (Please Print and Fill Out)

  Cadiz Country Club Membership Application

 I Hereby apply for (_______________) membership in the Cadiz Country Club and if selected will comply with its by-laws, rules and regulations. I understand that I am responsible for any and all indebtedness to the Club that has been approved by the Board of Directors and/or incurred by me for the use of the Club and its facilities. Resignation from Club membership must be submitted to the Board of Directors in writing.  

Signature_______________________________________________________________

Name____________________________________SS#___________________________

Address______________________________________Phone#_____________________

City, State, Zip______________________________, _____, ______________________

Place of employment_______________________________________________________

Years employed ____Position ___________________Avg. yearly income____________

Spouses Name____________________ Place of Employment______________________

 Have you held previous membership in The Cadiz Country Club? ___________

If yes when________

Have you been a member of another Country Club?______ If yes what club___________

No. of children (18 & under) ______________ (older than 18)_________________

If attending college please list name of Institution________________________________

 What was your last posted USGA Handicap_________

Please submit your last 20 scores to the Handicap Chairman.

 Equity Members Proposing this membership (5 signatures required)

___________________________________ ____________________________________

___________________________________  ____________________________________

___________________________________  ____________________________________

___________________________________________________________________________________

Club Use Only

Amount Paid__________        Initiation___________     Date Submitted ____/____/____

Board Approval____________                      Date approved/disapproved ____/____/____

Any fees, dues and taxes thereon must accompany this application