Membership Application
New Members Only!
 Membership begins Oct. 15, 2006
 valid thru December 31, 2007

First Name
Last Name
Address
Address 1
City
State
Zip Code
Work Telephone
Home Telephone
E-Mail

In case of
Emergency
Notify:

 Name  
Phone #  
Relationship  
WEEKDAY MEMBERSHIP ( 5 Days )

$ 1155 Single Weekday Membership

$ 2190 Member/Spouse Weekday

*$40.00 charge for installment plan
 
FULL MEMBERSHIP ( 7 Days )

$2000 Single Full Membership

$3150 Member/Spouse Full Membership

*$40.00 charge for installment plan
                    (To have electric cart inclulded, double membership fee)
LOCKER?

$35.00 Reserve a Locker
MEDICAL CONDITION? -  in case of an emergency
No 
Yes    
Please
explain if Yes

3 installments due 10/15, 1/03 and 3/03
I hereby make application for Membership, and if accepted, agree to abide by all terms, conditions and regulations of the club as they now exist, or as they may hereafter be amended.

PRINT THIS FORM BEFORE SUBMITTING 
AND MAIL WITH YOUR CHECK TO:
Westwood Country Club
850 Kings Highway
Woodbury, NJ 08096

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