APPLICATION FOR MEMBERSHIP

APPLICATION FOR MEMBERSHIP
Date of Application:
I hearby make application for the following Class of membership in Norfolk Yacht and Country Club. I agree, if elected, to abide by its Constitution, By-Laws, rules, and regulations.

Applicant Information
Proposed Member's Full Name

PrefixFirst NameMiddle NameLast NameSuffix
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Length of Time at Present Address
Email
example@example.com
Home Phone

Area CodePhone Number
Cell Phone

Area CodePhone Number
Date of Birth

MonthDayYear
Place of Birth
Date of Birth
Education
State the names of social, fraternal, civic, and business organization of which you are a member.
Business Information

Position Held

Name of Firm

Nature of BusinessWork Phone

Length of Service
Billing Address (if different from above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please upload a photograph of PROPOSED MEMBER AND DEPENDENTS when applicable. Anyone to receive membership privileges will need to be included.

Choose Photo

Cancelof
Do you grant permission for us to share your photo and a brief summary of background information submitted on this application in our private members' only Facebook group?
Please upload a photograph of proposed member and dependents when applicable.

Sponsors
Any member, regardless of membership class, may nominate or second a proposed member. One of the three must be a Class A or B member. Active Board members are not valid sponsors.

All three sponsors must also write a letter of recommendation addressed to the Secretary to accompany the application and submit a confidential sponsor questionnaire provided by the Membership Director upon completion of this application.
Proposed by

First NameLast Name
Proposer Email
example@example.com
Club Number
Length of Time Known
Phone Number

Area CodePhone Number
Endorsed by

First NameLast Name
Endorser 1 Email
example@example.com
Club Number
Length of Time Known
Phone Number

Area CodePhone Number
Endorsed by

First NameLast Name
Endorser 2 Email
example@example.com
Club Number
Length of Time Known
Phone Number

Area CodePhone Number
State the names of any additional members of the Norfolk Yacht and Country Club with whom you are personally acquainted or to whom you are related.

Dependent Information
SPOUSE (if applicable)
Spouse Name

PrefixFirst NameMiddle NameLast NameSuffix
Email
example@example.com
Cell Phone

Area CodePhone Number
Resides at Home Address of Primary Member Listed:
Date of Birth:

MonthDayYear
Place of Birth
Date of Birth
Education
State the names of social, fraternal, civic, and business organization of which you are a member.
Business Information

Position Held

Name of Firm

Nature of BusinessWork Phone

Length of Service
CHILDREN (if applicable)

If applying for a family membership, please provide the names and birthdates of dependents who will receive privileges of the Club under this membership.
Child 1

First NameLast Name
Relationship
Son, Daughter
Date of Birth

MonthDayYear
School (if applicable)
Date of Birth
Child 2

First NameLast Name
Relationship
Son, Daughter
Date of Birth

MonthDayYear
School (if applicable)
Date of Birth
Child 3

First NameLast Name
Relationship
Son, Daughter
Date of Birth

MonthDayYear
School (if applicable)
Date of Birth
Child 4

First NameLast Name
Relationship
Son, Daughter
Date of Birth

MonthDayYear
School (if applicable)
Date of Birth

Additional Questions

If applicable for the membership you are applying for.
Service Memberships
Active Duty Officer:
Expected Date of Separation:
Legacy Membership
Are/were your parents, grandparents, children, or grandchildren active members of NYCC?
If yes to either option, please state their names:
Reinstatement
Have you previously been a member of NYCC?
If yes, when did you resign?
Why are you interested in reinstating at this time?
Non-Resident Membership - Completion of an additional Residency Verification Addendum will also be required upon submission for a Non-Resident Application.
How often do you reside at the home address listed?
How often do you spend time in the Norfolk/South Hampton Roads area?
Do you primarily spend any other time in other locations, if yes, please state where.

Upon submitting your application your name will be posted on the bulletin board for four weeks and your application forwarded to the Membership Committee for their review and recommendation once all three letters of recommendation are received.

Privileges of the Club shall not be extended to any person applying for membership until they are formally elected by the Board of Governors and have paid the appropriate dues and fees.
Signature
Should be Empty:

Applicant Information