Southland Family Club

SOUTHLAND FAMILY CLUB P.O. BOX 601 BOWLING GREEN, KENTUCKY 42102-0601 (270) 535-2369 [email protected]

APPLICATION FOR MEMBERSHIP

To join the waiting list, applicants must mail this application with a $20 application fee (check only) to the above address. The $20 fee will be applied to the one-time $350.00 stock fee if an applicant joins when invited. The fee is not refunded to applicants who decline to join. Applicants who wish to move to the bottom of the list will be required to submit another $20 fee. Applicants will be invited by email and phone. It is the applicant’s responsibility to update the Treasurer with any changes in contact information. Applicants may be removed from the waiting list if contact attempts are unsuccessful at the time of invitation.

The $350 stock fee is refundable upon resignation from the club, provided the member gives a 31-day notice and has no balance due. Current rates for annual dues are shown below. These rates apply to all members, regardless of marital status. Children who are under the age of 3 as of May 1 are free.

APPLICATION FEE ANNUAL DUES 2016 $20.00 Member – no child $520.00 Member – 1 child $545.00 NEW MEMBER STOCK FEE Member – 2 children $570.00 $350.00 Member – 3 children $595.00 Member – 4 children $620.00 Member – 5 + children $645.00

The following information is submitted for the records of Southland Family Club

Member Name ______Home Phone______

Street Address______State______Zip ______

Occupation ______Cell or Business Phone______

Spouses Name______Home Phone______

Occupation______Cell or Business Phone______

E-Mail Address ______

Children 1______Date of Birth______4______Date of Birth______

2______Date of Birth______5______Date of Birth______

3______Date of Birth______6______Date of Birth______

Note: Stock Certificate will be issued in joint names unless specifically requested otherwise

I hereby submit my (our) application for membership in The Southland Family Club of Bowling Green, Inc. In doing so, I (we) agree to comply with all posted rules & by-laws governing the operation of the club. The Southland Family Club is a private club that reserves the right to accept or reject any/or all applications for membership.

Signature______Date______

RECOMMENDED BY ______Phone Number______

EACH APPLICANT MUST BE RECOMMENDED BY AT LEAST TWO MEMBERS OF THE CLUB.

FOR OFFICE USE ONLY

Date fee and application received______