Application for Membership of 67 Pall Mall London

Application for Membership of 67 Pall Mall London
Personal Details
Your full name

TitleFirst NameLast Name
Gender
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Your Address

Address line 1

address line 2

Address line 3Address line 4

Postal codeCountry
Landline Number
Mobile number
Email Address
Date of birth

DayMonthYear
2 digit day, 2 digit month, 4 digit year
Nationality
occupational sector
others
Company Name
company address

address line 1

address line 2

address line 3address line 4

Postal codeCountry
personal assistant details (if applicable)

First NameLast Name
contact number
Email address
Personal interests
Other personal interests
Dietary Requirements
Other intolerances
Membership
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Annual Membership
(£2,000 joining fee)

£2,750.00



Under 30 Membership
£1,250.00



Wine professional Membership
(permanently employed in the wine trade, £2,000 joining fee)

£1,250.00



Overseas Annual Membership
15 visits in total across any 67 Pall Mall Club globally (permanent resident overseas, £2,000 joining fee)

£1,250.00



Joint Membership
(per joint membership)

£600.00



Life membership
Lifetime access, exclusive privileges and no joining fee

£35,000.00
Investment opportunities are also available. Please email Matilde.Monticelli@67pallmall.com to enquire.
Joint Member Details
Full Name

First NameLast Name
contact number
Email address
Date of birth

DayMonthYear
2 digit day, 2 digit month, 4 digit year
Nationality
occupational sector
Company Name
company address

address line 1

address line 2

address line 3address line 4

Postal codeCountry
Personal interests
Other personal interests
Dietary Requirements
partner's Photo

to be used for internal uses only
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Biography

The biography you provide below will be used to support your application.
Photo

to be used for internal uses only
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Proposer

First NameLast Name
Seconder

First NameLast Name
how did you hear about us?

Other
What are you hoping to get out of your membership?
I hereby apply for membership of 67 Pall Mall London ("The Club"). Should my application for membership be approved, I agree to be bound by the Club Rules, by signing this agreement I give my consent for the processing of my personal data as outlined in the Club's Privacy Policy, and for my information to be used for internal Club purposes only. Additionally, I authorise 67 Pall Mall London to make appropriate due diligence enquiries in relation to my application.
Signed
Dated

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Application for Membership of 67 Pall Mall London

Personal Details

Membership

Joint Member Details

Biography