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Membership Application ~
Please use the following form to complete your New Membership Application through our secure, on-line program. Once completed, a member of our staff will be in contact with you to welcome you to membership and schedule your orientation tour. Welcome to Ivy Hills Country Club!
Membership Type:
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Unlimited Golf
Full Golf
Associate Golf (limited quantities)
Social Non-Resident
Social Resident
Last Name:
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First Name:
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Date of Birth:
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Spouses First Name:
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Spouse Date of Birth:
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Child and Age:
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Child and Age:
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Child and Age:
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Home Street Address:
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City:
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State:
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Zip Code:
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Home Telephone:
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(
)
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First three digits
Second three digits
Last four digits
Cell Phone:
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(
)
-
First three digits
Second three digits
Last four digits
E-Mail:
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Billing Address:
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Employed By:
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Job Title with Business:
Credit Card Type:
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Visa
Mastercard
American Express
I authorize Ivy Hills to charge my card the appropriate initiation fee for my membership:
Please charge my card on file each month for the balance due. I understand there is a 2% convenience fee for this service.:
I agree to all terms and condtions listed in the Ivy Hills Membership Application.:
Signature:
*
Enter security code:
Referring Member: (not required):