(To apply for membership, you can print this form, fill out the information, and mail it to the address below.)

LOPEZ ISLAND GOLF CLUB, Inc.

PO Box 124

Lopez Island WA 98261

360.468.2679

APPLICATION for CERTIFICATE MEMBERSHIP

 

A membership shall be given to those individuals who purchase membership

in accordance with the Lopez Island Golf Club By-Laws. A Certificate of Membership

shall be issued entitling the holder to the rights and privileges specified in the Club

By-Laws. Upon acceptance for membership the applicant shall remit to the treasurer

monies to cover the cost of the value of the certificate, the initiation fee (if applicable) and the annual dues.

To the Board of Trustees,

I, ________________________________________, hereby make application for a

membership certificate in the Lopez Island Golf Club, Inc. This application is made

with full knowledge and understanding of the fees, charges, and other financial

obligations of membership privilege. I hereby promise to meet all such financial

obligations promptly, including such special assessments as may be made by the

Board of Trustees and/or the membership.

A membership certificate in the Lopez Island Golf Club entitles the holder to

membership in the Golf Club and to enjoy all the privileges therein. The owner

further agrees to uphold the By-Laws, the Articles of Incorporation and the Rules

And Regulations of the Lopez Island Golf Club, Inc. in its objective to maintain the

Club in perpetuity.

The following named certificated member of the Lopez Island Golf Club, Inc. has

agreed to sponsor this applicant and to submit a letter of recommendation to the Trustees.

_________________________________

Name of sponsor                                                      

Signature of Applicant ________________________________________ Date________

Mailing Address _____________________________________________

______________________________________________

Email Address  ___________________________________

Phone __________________________

Certificate #  _______________________

Upon acceptance for membership the applicant shall remit to the Treasurer monies to cover

the cost of the value of the certificate, the initiation fee (if applicable), and the annual dues.