Membership Application

MEMBER INFORMATION

I am applying for membership in the following category (please choose one):

Have you previously been a SBCC member?

Yes

Personal Information

Title:

Date of Birth:

First Name:

Last Name:

Home Address:

City:

State:

Zip Code:

E-mail:

Cell Phone:

Marital Status:

Anniversary Date:

Business Information

Company Name:

Type of Business:

Length of Employment: (In Years)

Title:

Business Phone:

Business Address:

City:

State:

Zip Code:

Email Address:

SPOUSE INFORMATION

Personal Information

Title:

Date of Birth:

First Name:

Last Name:

E-mail:

Cell Phone:

Business Information

Company Name:

Type of Business:

Length of Employment: (In Years)

Title:

Business Phone:

Business Address:

City:

State:

Zip Code:

E-mail:

DEPENDENT INFORMATION

Please only list children under the age of 23 who are living at home, attending school full time, or in the military.

Names:

Date of Birth:

REFERENCES

Please help us thank the club member(s) who recruited you to the club (if anyone), by listing them below:

Recruited by Member 1:

Recruited by Member 2:

Personal references (can be out of town and the same person(s) as listed above.)

Reference 1:

Reference 2:

Reference 3:

REFUND AND RESIGNATION

IT IS AGREED THAT the applicant may resign from SBCC by giving written notice to SBCC. The effective date of the resignation will be the date SBCC receives the applicant’s written notice. There is a two year waiting period to rejoin if you choose to resign. All accrued dues and other charges for which the applicant is liable are due upon effective date of resignation. No stock shall be transferred or sold except to a surviving spouse or in the case of a corporate membership, as is provided in the bylaws. The applicant agrees that in the event of a corporate reorganization or personal divorce, this membership is not divisible, and this membership shall be allocated by agreement of all claimants, or in the absence of agreement, by court order. Such allocations are subject to the sole approval of the Board of Directors. The successor to the membership shall execute all necessary papers and pay all allocation fees required by SBCC. Membership does not confer any ownership of SBCC’s property or assets.

BYLAWS

Applicant and Corporate Designee (if applicable) agree to conform to and be bound by the Bylaws and Rules and Regulations of SBCC, as they are amended from time to time.

Date:

Signature

MEMBER QUESTIONNAIRE
(Optional)

In addition to the information you have already provided us, we would like to get to know you better. We like to feature our new members in our weekly newsletter. Please take a moment to fill out the quick questionnaire below so current members can get to know you! Welcome to SBCC!

Are you from the Scottsbluff area?

If not, where did you relocate from?

What do you and your family’s hobbies include?

Why did you decide to join the Scotts Bluff Country Club?

HOW DID YOU HEAR ABOUT US?

APPLICATION PROCESS

Your temporary account will be established immediately. Your application will be reviewed by the Board of Directors within 60 days of receipt. Your application is considered approved unless you are notified by the General Manager.

For additional information or questions, please feel free to reach out to us via phone at (308) 632-8297 or visit our website at www.scottsbluffcountryclub.com.

For Office Use Only

Initiation Fee:

Stock Certificate:

Stock Certificate #:

Join Date:

* Denotes Required Field

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