Download the application or fill out the form below to start the membership application process. Download Membership Application Please enable JavaScript in your browser to complete this form.Name *FirstLastAddressAddress Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeSSN #Driver's License #EmployerSpouse Name and DOBSpouse Phone #Spouse EmployerEmail *Previous Club Membership (if applicable) Children Home Signature Children at Home (first name & DOB)Check OneResident $385Intermediate Non-Resident 4340Non-Resident outside 40 mile radius of ElkinClubhouse $135Young Executive (30-39) $310Young Adult (21-29) $220Student (13-20) $500 annual payment onlyReferred by:Referring MemberMemberBoard MemberA. Initiation fee must be paid in full with application. B. Reinstatements in good standing must have quarterly dues attached, along with membership certificate number. Check here for reinstatement C. Membership must remain active for a minimum of two years, eight quarters, or initiation fee will be forfeited. Application for reinstatement in the future will require full initiation fee in effect at time of request for reinstatement. D. Dues are payable monthly, quarterly or annually in advance, within 30 days from beginning of quarter or year. E. Payment after 30 days is subject to 1 1/2% finance charges. Two months past due is subject to $50.00 late payment fee, plus finance charges. F. Resignations must be in writing to the president or secretary of the club. Bank ReferenceSignature Clear Signature Submit
