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Membership Application

The fields in bold are required fields, so please be sure to complete them.
Click Here to Read the Colony Club Bylaws
Required field: The applicant agrees to conform and be bound by the bylaws, rules and regulations of the Colony Club, as that may be amended from time-to-time.
Title:
First Name:
Last Name:
Home Address (street):
City:
State:
Zip Code:
   
Home Phone:
Cell Telephone:
Preferred E-mail Address:
 
Date of Birth:
Gender:    Male  Female  
Marital Status:    Married  Single  Widowed  
Spouse's Name:
Children's Name(s) and
Date(s) of Birth:
(if married please state first and last names)
Employment / Professional Information
Work Title:
Firm / Employer Name:
Work Address:
City, State, Zip Code:
Work Telephone:
Fax Number:
Type of Business or Employment:
 
Preferred Billing Address:
    Home   Business  
   
References
*Sponsor:
**Co-Sponsors(3):
 
 
 

***I am applying for membership in the following category:
Resident:
Non-Resident:
Resident B:
Senior Resident:
Senior Retired:
 
Please list other organization/club affiliations:
 
Colony Club Interests:
Primary reason for joining:
 
Major Usage Interests:
Luncheon:
Dinner:
Club Function:
Private Entertaining:
Business Entertaining:
 
Other:
  
 
Club Participation Interests:
  House Committee: Membership Committee: Special Functions:  
 
Other:
  
     
Unique Talents
Available for Club Benefit:
  
 
After you submit this online application one of our staff will contact you for information to activate your membership.
 

 
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