Amity Club Membership Application

Amity Club Membership Application
Completion of this form will generate a message directly to the Amity Club leadership.

Please Note: To submit your application for membership, upon completion, a payment of annual dues is required.

In accordance to the By-Laws of Amity, I agree to the annual dues payment of:

Social Plus Golf Membership: $550
Social Membership: $395

$80 of your dues are a charitable donation.
I hereby apply for membership in Amity Club, and, if accepted, agree to abide by all the rules and regulations at present in force, or hereafter promulgated for the operation of the Club.In accordance to the By-Laws of Amity.
Name

First NameLast Name
Nickname (as you want it to appear on a name tag)
Email
example@example.com
Home Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Mobile Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Office Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Fax Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Company Name
Or, you may enter "Retired"
Job Title
Office Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Website
Birthday

MonthDayYear
Date
Wife or Significant Other

First NameLast Name
Message
Anniversary

MonthDayYear
Date
Children's names and birthdays
Synagogue or Church affiliation
Biography - Birthplace/Hometown
Interests and Hobbies
College Attended
Profession
Which of these volunteer committee(s) would you consider?
Charitable Affiliations (if any)
Referred by the following member(s)
Why are you considering joining Amity?
Upon submission, you will be sent to PayPal for the Membership Application payment.
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Social Plus Golf Membership
$550.00 Quantity

Social Membership
$395.00 Quantity

Total

$0.00
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Amity Club Membership Application

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