Membership Application

Please fill in the form below to begin the application process.

Credit card information and signature must be given in person. Click here to print the PDF form and bring it with you to Otsego Club.

Today's Date

Applicant's Name

Membership Type Applying for

Type

Category

Payment Option

Sponsoring Family Information

Name

Relationship

Account #

PERSONAL

Name (Last, First, Middle)

DOB

Spouse (Last, First, Middle)

DOB

Email Address

Alt. Email Address

Permanent Residence (all communications from the Club will be directed to this address and phone number)

Number, Street

City, State, Zip

Telephone

Alt. Phone

Fax

Secondary Residence

Number, Street

City, State, Zip

Telephone

Alt. Telephone

Fax

Club Membership provides privileges for your unmarried children, up to four, under the age of 24 years and living at home or in school. Additional children will be charged. (See rate schedule)

 

Name

Date of Birth

1.

2.

3.

4.

BUSINESS

Applicant's Occupation/Title

Company Name

Mailing Address

City

State

Zip

Telephone

Years in Present Employment

Spouse's Occupation/Title

Company Name

Mailing Address

City

State

Zip

Telephone

Years in Present Employment

SOCIAL

Additional Club Memberships

1.

Current Member

  

Former Member

  

# of Years

2.

Current Member

  

Former Member

  

# of Years

3.

Current Member

  

Former Member

  

# of Years

PERSONAL REFERENCES (3) (Preferably Otsego Club Members, if available)

Name

Relationship

Years Known

Name

Relationship

Years Known

Name

Relationship

Years Known

CONFIRMATION OF ACCEPTANCE & ACKNOWLEDGMENT

If accepted as a Member, I, individually and on behalf of my family, hereby agree to conform to and be bound by the Conditions, Rules and By-Laws of the Club, as they may be amended from time to time. Further, my signature below confirms my understanding of the Conditions, Rules and Bylaws and the items noted in the application and assures the accuracy of completed information. Conditions and By-Laws may change without prior notice and will be in full force and effect equally to all Members as of date enacted.