Page 14 - 2024 Membership Information Overview
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MEMBER CANDIDATE INFORMATION
Date___________________
Name_________________________________________________________________________________ Nickname___________________________________
Home Address_____________________________________________________________________________________________________________________
City______________________________________________________________________________________ State________________ Zip________________
Mobile____________________________ E-mail________________________________________________________________________________________
Date of Birth___________________Social Security #_____________________________Driver’s License#____________________________State________
BUSINESS INFORMATION
Company Name________________________________________________________Type of Business_____________________________________________
Title______________________________________________________________________________________Length of Employment______________(years)
Business Address________________________________________________________ City_____________________ State___________ Zip_____________
Business: Phone__________________________ E-mail__________________________________________________________________________________
Current Memberships in other clubs: _________________________________________________ _______________________________________________
Memberships in other clubs (last 10 years): ___________________________________________ ________________________________________________
GHIN (required): ________________________________________________ Handicap: _______________________________________________________
Member Sponsor: ___________________________________________________________________________________________________________________
FAMILY INFORMATION
Marital Status: Single Married
Spouse Name________________________________________________________________Date of Birth___________________________________________
Child __________________________ Date of Birth__________________ Child __________________________ Date of Birth__________________
Child __________________________ Date of Birth__________________ Child __________________________ Date of Birth__________________
Upon approval, you have my consent to include my information in the DNGC Member Roster. Yes No
I understand that Membership approval is conditioned on a background check. I authorize Dallas National Golf Club to
thoroughly investigate all statements contained in my application and authorize references to disclose information regarding my
character and general reputation, without giving me prior notice of such disclosure. I release Dallas National Golf Club and all
references listed above from any and all claims, demands or liabilities arising out of or related to such investigation or disclosure
Date:_________________________ Signature:__________________________________________________________________
