Fillable PGSA North HillsCC Appl Form2020 Fillable Form

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PGSA North HillsCC Appl Form2020 Fillable Form

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Membership Application
North Hills Country Club • 200 LIE North Service Road • Manhasset, NY 11030
516-627-9100
• memberdrive@northhillscc.com
www.northhillscc.com
NORTH HILLS
COUNTRY CLUB
Type of Membership Desired
Check One Membership Category:
Membership Classification
Annual Dues Annual Dues Initiation
Full Price - 25% Discount Fee
o Regular Membership $13,200.00 $9,900.00 Waived
Regular Members have access to all of the facilities including unlimited use of the golf course. This membership is a
family membership that extends privileges to spouse and all children under 26 years of age. This membership requires a
Sponsor. All Regular Members and their Sponsors will receive a 25 % ($3300) reduction in dues for two (2) years.
Monthly Fees Capital Projects Food & Beverage Minimum Bag Storage & Range
$1980 per year $1080 per year $1800 per year $250.00 per year
Membership Classification Annual Dues Annual Dues Initiation
Full Price - 25% Discount Fee
o Executive (Ages 26 to 30) $3,000.00 $2,250.00 N/A
o Executive (Ages 31 to 34) $5,000.00 $3,750.00 N/A
o Executive (Ages 35 to 39) $7,000.00 $5,250.00 N/A
Executive Membership is available to any person under forty years of age. Executive Members have access to all of the
facilities of the Club including unlimited use of the golf course. This membership requires a Sponsor. Upon reaching the
age of forty they must become Regular Members if they wish to stay at the Club. All Executive Members and their Sponsors
will receive a 25% ($750, $1250, $1750 respectively) Executive Membership reduction in their dues for two (2) years.
Monthly Fees* Capital Projects* Food & Beverage Minimum Bag Storage & Range
$1980 per year $1080 per year $900 per year (Ages 31-34) $250.00 per year
$1800 per year (Ages 34-39)
* New Members between the age of 26 and 30 joining the Club as an Executive Member will receive an additional 25% ($765)
reduction in monthly and capital fees until 31 and Children of Regular Members (Legacy) between the ages of 26 to 30 joining the
Club as an Executive Member will receive an additional 50% ($1530) reduction in monthly and capital fees until age 31.
Membership Classification Annual Dues Annual Dues Initiation
Full Price - 25% Discount Fee
o Weekday Membership $11,300.00 $8,450.00 Waived
Weekday Members have access to all of the facilities of the Club, however, can only play golf on weekdays and two
times per month on weekends as a guest. Weekend play is subject to an additional guest fee of $90 for each round of
golf. This membership requires a Sponsor. All Weekday Members and their Sponsors will receive a 25% ($2850) Weekday
Membership reduction in their dues for two (2) years.
Monthly Fees Capital Projects Food & Beverage Minimum Bag Storage & Range
$1980 per year $1080 per year $1800 per year $250.00 per year
Membership Classification
Annual Dues Annual Dues Initiation
Full Price - 25% Discount Fee
o Pool, Social Tennis Membership $6,800.00 $5,100.00 Waived
Pool, Social Tennis Members have access to all Club facilities with the exception of the golf course. It is a year-round
membership. This membership requires one Sponsor. All Pool, Social, Tennis Members and their Sponsors will receive
a 25% Pool, Social, Tennis Membership reduction ($1700) in their dues for two (2) years.
Monthly Fees Capital Projects Food & Beverage Minimum Bag Storage & Range
$1980 per year N/A $1800 per year N/A
Membership Classification Annual Dues Annual Dues Initiation
Full Price - 25% Discount Fee
o Family Pool, Social Tennis $6,300.00 $4,725.00 Waived
Same as Pool, Social Tennis Membership, however, applicant must be child of a Regular Member. All Family Pool, Social,
Tennis Members and their Sponsors will receive a 25% Family Pool, Social, Tennis Membership reduction ($1575) in their
dues for two (2) years.
Monthly Fees Capital Projects Food & Beverage Minimum Bag Storage & Range
$1980 per year N/A $1800 per year N/A
Membership Classification Annual Dues Annual Dues Initiation
Full Price - 25% Discount Fee
o Social Membership $3,700.00 $2,775.00 N/A
Social Members have access to all the facilities in the Clubhouse–Dining, Card Room, Bowling, however, cannot use any
of the other recreational facilities. These members do not have voting privileges. This membership requires One Sponsor.
All Social Members and their Sponsors will receive a 25% Social Membership reduction ($925) in their dues for two (2) years.
Monthly Fees Capital Projects Food & Beverage Minimum Bag Storage & Range
$1980 per year N/A $1800 per year N/A
Personal Information
Name ______________________________________________________________________________________________________________________
Primary Address ____________________________________________________________________________________________________________
Street City State Zip Code
Alternate Address __________________________________________________________________________________________________________
Street City State Zip Code
Home Telephone Number ___________________________________ Cell Phone Number ______________________________________
Date of Birth _______________________________________________ E-mail Address _________________________________________
Spouse/Signicant Other: Name ____________________________________________________________________________________________
Spouse/Signicant Other: E-mail Address ____________________________________________________________________________________
Spouse/Signicant Other: Date of Birth _______________________________________________________________________________________
Spouse/Signicant Other: Home Telephone Number __________________________________________________________________________
Spouse/Signicant Other: Cell Phone Number ________________________________________________________________________________
o
Single o Married o Widowed o Signicant Other
Please list your dependent children 26 years of age or younger
Name Date of Birth Male Female
___________________________________________________________ ____________________________ o o
___________________________________________________________ ____________________________ o o
___________________________________________________________ ____________________________ o o
___________________________________________________________ ____________________________ o o
Business Information
Applicant’s Occupation and/or Nature of Business or Profession ____________________________________________________________
__________________________________________________________________________________________________________________________
Name of Company ________________________________________________ Title _________________________________________________
Business Address _________________________________________________________________________________________________________
Street City State Zip Code
Business Telephone Number _______________________________________ E-mail Address _______________________________________
Spouse/Signicant Other Occupation and/or Nature of Business or Profession ________________________________________________
___________________________________________________________________________________________________________________________
Name of Company ________________________________________________ Title __________________________________________________
Business Address _________________________________________________________________________________________________________
Street City State Zip Code
Business Telephone Number _______________________________________ E-mail Address _______________________________________
Statement & Newsletter Preference
E-mailed Newsletters o Home E-mail o Business E-mail
Mailed Statements
I prefer to receive my monthly billing at: o Home o Business
I prefer to receive my general mail at: o Home o Business
D
o you play golf? ____________________________ How long have you played golf? _______________________ USGA Handicap _________
Does your spouse play golf? __________________ How long has your spouse played golf? ________________ USGA Handicap _________
Reference Information
Please list membership in other Clubs, fraternities or organizations and positions held _____________________________________________
_________________________________________________________________________________________________________________________________
_ I am acquainted with the following North Hills Country Club Members:
Sponsor __________________________________________________________________________________________ for _______________ years.
Name _____________________________________________________________________________________________ for _______________ years.
Name _____________________________________________________________________________________________ for _______________ years.
Credit References
Banks
(1) Name ________________________________________________ (2) Name ____________________________ ______________________
Address _________________________________________________ Address _________________________________________________
Street Street
_________________________________________________________ _________________________________________________________
City State Zip Code City State Zip Code
Personal
(1) Name ________________________________________________ (2) Name ________________________________________________
Address _________________________________________________ Address _________________________________________________
Street Street
_________________________________________________________ _________________________________________________________
City State Zip Code City State Zip Code
Credit Card Information
Type ____________________________________________________ Card Number ___________________________________________ __________
Expiration Date __________________________________________ Security Code ______________________________________ ____________
Name on Card ____________________________________________ Telephone Number Associated with Card __________________________
Billing Address for Card ___________________________________________________________________________________________________
Street City State Zip Code
Authorization and Agreement
The undersigned hereby conrms that the information provided in this application is true, complete and correct, and hereby authorizes
North Hills Country Club (the “Club”), through its representatives, to conduct such inquiry into the undersigned’s nancial condition
and professional background as it deems necessary and appropriate.
The undersigned acknowledges and agrees that (i) this application for membership is submitted in connection with the 2020
Membership Drive of the Club, and (ii) by submitting this application, the undersigned is making a commitment to remain a member
of the Club for a minimum of two years, beginning on their start date, in exchange for the two year 25% dues discount. Any deposits
are due upon submission of this application. Any member wishing to resign prior to two years, will be responsible for any remaining
dues and fees. Exceptions may be made for those relocating more than 75 miles from the club.
If this application is accepted, and the applicant is admitted in accordance with the formal admission procedures of the Club, the
undersigned agrees to observe and be bound by the Bylaws and the House and Course Rules and Regulations of the Club in effect
which may be updated from time to time. The undersigned agrees to maintain a current valid credit card on le with the Club at all
times, and hereby authorizes the Club to charge such credit card for any amounts owed to the Club, including amounts reected
on monthly invoices, that are more than Forty Five (45) days past due. Should legal action be required to collect amounts due, I the
undersigned will reimburse NHCC for its reasonable attorney’s fees and other costs of collection. Any unpaid amounts will bear
interest and be subject to late fees in accordance with NHCC policy.
If the undersigned is suspended from NHCC for any reason, including non-payment of dues, he/she will forfeit all future dues credits.
The undersigned hereby acknowledges and agrees that he/she is personally liable and responsible for all nancial obligations relating
to his/her membership, including any obligations relating to the use of the Club by his/her family members and guests.
The undersigned agrees to pay all dues and assessments beginning May 1, 2020 and future dues and assessments as prescribed
and levied by the Club until the share is surrendered or proper resignation is submitted and accepted.
Name of Applicant (Print) _________________________________________________________________________ Date __________________________
Signature of Applicant ____________________________________________________________________________ Date __________________________
OFFICE USE ONLY
ACCEPTED THIS DAY OF 20__________________________________ .
MEMBERSHIP CHAIRPERSON .
PRESIDENT .
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Notes:
North Hills Country Club • 200 LIE North Service Road • Manhasset, NY 11030
516-627-9100
• memberdrive@northhillscc.com
www.northhillscc.com
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PGSA North HillsCC Appl Form2020 Fillable Form

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Completed 24 November 2020

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