MyVIPClubs Membership Application

MyVIPClubs Membership Application
Membership is by application and referral only. Each application is reviewed individually, acceptance is not guaranteed, and review generally takes 2–4 weeks. Applicants will be notified by email regarding their membership status. There are 11 sections in this application.
Section 1 — About You
Full Legal Name

First NameLast Name
Preferred Name / Nickname
Date of Birth

MonthDayYear
Are you 21 years of age or older?
Email Address
example@example.com
Mobile Number
Please enter a valid phone number.Format: (000) 000-0000.
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
LinkedIn Profile URL
Instagram or Other Social Profile
Relationship Status
How did you hear about MyVIPClubs?
Section 2 — Your Referral
Referral information is required and will be verified. The referral must come from a current MyVIPClubs member.
Referring Member's Complete Name

First NameLast Name
Referring Member's VIP Number
Your Relationship to the Referring Member
How long have you known the referring member?
Does the referring member know you personally?
Section 3 — Professional Information
Current Employer / Company
Industry / Profession
Job Title / Position
Are you a business owner or entrepreneur?
Section 4 — Membership & Interests
What types of establishments or experiences do you frequent?

Other
How often do you dine out or visit hospitality / entertainment venues?
Do you typically visit venues alone, as a couple, or with a group?
Are you interested in members-only events and experiences?
Are you interested in receiving invitations, special offers, or venue updates?
Section 5 — Your VIP Preferences
These preferences help participating venues recognize and personalize your experience. Preference fulfillment is subject to venue availability and policies.
Favorite foods / cuisines
Favorite restaurants or types of restaurants
Preferred beverages / cocktails
Dietary restrictions, food allergies, or sensitivities
Favorite wine, spirits, beer, or non-alcoholic beverages
Preferred seating
Preferred atmosphere
Music / entertainment preferences
Smoking / cigar preferences where applicable
Typical special occasions celebrated at venues

Other
Any hospitality details or personal preferences a venue should know
What makes an experience feel truly VIP to you?
Do you consent to MyVIPClubs sharing relevant member preferences with participating venues to personalize your experience?
Section 6 — Member Profile & Recognition
Are there any details you do NOT want shared with venues?
Optional additional notes to help a venue recognize or serve you appropriately
Section 7 — Member Standards & Discretion
Please acknowledge the following standards
Section 8 — Gratuity Acknowledgment
I understand that VIP recognition and member benefits do not replace appropriate gratuity, and I agree to tip appropriately for service received.
Section 9 — Privacy & Information Consent
Please acknowledge the following privacy and information consent statements
Section 10 — Identity & Application Verification
I authorize MyVIPClubs to verify my application information and referral.
Photo will be used for membership card if application is approved.
Optional Applicant Photo Upload

Cancelof
Section 11 — Final Certification & Signature
Final certification
Electronic Signature / Full Name
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Applications are individually reviewed. Please allow approximately 2–4 weeks for review. You will be notified by email regarding your membership status.
Should be Empty:

MyVIPClubs Membership Application

Section 1 — About You

Section 2 — Your Referral

Section 3 — Professional Information

Section 4 — Membership & Interests

Section 5 — Your VIP Preferences

Section 6 — Member Profile & Recognition

Section 7 — Member Standards & Discretion

Section 8 — Gratuity Acknowledgment

Section 9 — Privacy & Information Consent

Section 10 — Identity & Application Verification

Section 11 — Final Certification & Signature