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* I hereby apply for membership and the resultant rights and privileges therein. I understand my name(s) and phone number(s) will be listed in the Member Directory available to Members only and is not used for solicitation purposes. I understand.

I understand

* I WOULD LIKE TO APPLY FOR MEMBERSHIP IN THE FOLLOWING CATEGORY:

Family Golf $388/m. $4000 Initiation
Jr. Family Golf (21-35yrs) $310/m. $4000 Initiation
Single Golf $292/m. $4000 Initiation
Jr. Single Golf (21-35yrs) $233/m. $4000 Initiation
Social $165/m. Initiation $1000

* Full Name

* Date of Birth

* Address

* City, State

* Zip code

* Email:

* Phone

* Employer

* Occupation

Does your spouse golf?

Spouse Name

Spouse Email

Spouse Date of Birth

Spouse Employer:

Spouse Job Title:

Anniversary:

Child #1 Name & DOB:

Child #2 Name & DOB:

Child #3 Name & DOB:

Child #4 Name & DOB:

Child #5 Name & DOB:

Nanny

Membership bylaws require the Member to pay dues and all other additional ancillary charges to your member account by auto billpay. First months dues and initiation due at enrollment. Select credit card type:

Visa
Mastercard
American Express
Discover

Card Holder Name:

Card number:

Expiration:

I would like to add the following services to my account:

Men's Golf Association $100/year (required with Golf Membership)
Men's Locker Rental-Half $80/year
Men's Locker Rental-Full $115/year
Men's Club Care-Bag Storage $105/year (required with Golf Membership)
Men's Handicap Services $30/year
Ladies' Golf Association $35/year
Ladies' Locker Rental-Half $40/year
Ladies' Locker Rental-Full $80/year
Ladies' Club Care-Bag Storage $105/year
Ladies' Handicap Services $30/year
I would like to be contacted by a Men's Golf Association Ambassador
I would like to be contacted by a Ladies' Golf Association Ambassador
Pull Cart Storage $50/year
Jr. Club Storage $35/annually

A semi-annual food minimum ($300 every 6 month period) is required for all Membership Levels. (1)Club storage (1) Men's Golf Association, and Hole-in-One Fund participation is required per Golf Membership Levels. Membership Resignation Policy: Resignations are accepted once a year on July 1st. A 30 day written notice prior to the July 1st renewal date is required for termination.

I understand. *

* Requested start date

Discount Code

* Referred by/Member Sponsor

I hereby apply for membership at The Field Club of Omaha. If this membership application is accepted, I agree to comply with and be bound by the Club’s Rules and Regulations as they may be amended from time to time. I understand and agree that if the Club does not accept this application, all funds paid for the membership will be promptly refunded, and this application will be cancelled and will not be binding on either party. The Club reserves the right to decline this membership application at any time in its sole discretion. If my application is approved my membership will begin on the date a duly authorized representative of the Club executes the “Approved By” line. Approved by_________________________on this ____date of _______, 201_.

Applicant Digital Signature

Application for Private Club Membership

APPLICATION FOR PRIVATE CLUB MEMBERSHIP