Membership Application Form

for Your State

This Membership Application Form can be used by any organization or business that screens applicants for membership. This form requests detailed information regarding the applicant, his or her spouse and requires the applicant provide two references.

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This Membership Application Form is for use by any organization which screens applicants for membership and can easily be tailored to include your organization’s name or logo. This application requests current information regarding the applicant including his or her name, date of birth, social security number, address and phone numbers. In addition, the application requests information regarding applicant’s employment, emergency contact information, references and detailed information regarding his/her spouse if they are also seeking membership and the name and age of any children if membership privileges are desired. It is important that this Membership Application Form be completed in writing. A written application will prove helpful in the event there are disagreements or misunderstandings regarding an applicant’s qualification for membership.

This Membership Application requests the following:
  • Applicant Information: Name of applicant, date of birth, social security number, current phone number and address, how long at this address, if applicant rents or owns and the amount of monthly payment or rent;
  • Employment Information: Applicant’s current employer and employment address, how long employed, email address and work phone number, position held and yearly income;
  • Emergency Contact: Name, address and phone number of emergency contact person and their relationship to the applicant;
  • Spouse Information: If joint membership is desired, all pertinent information regarding the spouse including social security number and employment information;
  • Children’s Privileges: If applicant desires membership privileges for their children, the children’s names and ages;
  • References: The name, address and phone number of two references;
  • Signatures: The applicant and spouse (if applicable) must sign and date this application.

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This attorney-prepared packet contains:
  1. General Instructions and Checklist
  2. Membership Application Form
State Law Compliance: This form complies with the laws of all states
This is the content of the form and is provided for your convenience. It is not necessarily what the actual form looks like and does not include the information, instructions and other materials that come with the form you would purchase. An actual sample can also be viewed by clicking on the "Sample Form" near the top left of this page.
 
 
Membership Application Form

 

 
 
YOUR ORGANIZATION Name
MEMBERSHIP APPLICATION
Applicant Information
Name:
Date of birth:
SSN:
Phone:
Current address:
City:
State:
ZIP Code:
Own     Rent     (Please circle)
Monthly payment or rent: $
How long?
Employment Information
Current employer:
Employer address:
How long?
Work Phone:
E-mail:
Fax:
City:
State:
ZIP Code:
Position:
Hourly     Salary     (Please circle)
Yearly  income: $
Emergency Contact
Name of a relative not residing with you:
Address:
Phone:
City:
State:
ZIP Code:
Relationship:
Spouse Information if joint membership desired
Name:
Date of birth:
SSN:
Phone:
Spouse Employment Information
Current employer:
Employer address:
How long?
Work Phone:
E-mail:
Fax:
City:
State:
ZIP Code:
Position:
Hourly     Salary     (Please circle)
Yearly income: $
References
Name
Address
Phone
 
 
 
 
 
 
Children if membership privileges desired
Name and age:
Name and age:
Name and age:
Name and age:
Signatures
I authorize the verification of the information provided on this form as to my credit and employment. I have received a copy of this application.
Signature of applicant:
Date:
Signature of spouse (only for joint membership):
Date:
 
Number of Pages3
DimensionsDesigned for Letter Size (8.5" x 11")
EditableYes (.doc, .wpd and .rtf)
UsageUnlimited number of prints
Product number#32688
This is the content of the form and is provided for your convenience. It is not necessarily what the actual form looks like and does not include the information, instructions and other materials that come with the form you would purchase. An actual sample can also be viewed by clicking on the "Sample Form" near the top left of this page.
 
 
Membership Application Form

 

 
 
YOUR ORGANIZATION Name
MEMBERSHIP APPLICATION
Applicant Information
Name:
Date of birth:
SSN:
Phone:
Current address:
City:
State:
ZIP Code:
Own     Rent     (Please circle)
Monthly payment or rent: $
How long?
Employment Information
Current employer:
Employer address:
How long?
Work Phone:
E-mail:
Fax:
City:
State:
ZIP Code:
Position:
Hourly     Salary     (Please circle)
Yearly  income: $
Emergency Contact
Name of a relative not residing with you:
Address:
Phone:
City:
State:
ZIP Code:
Relationship:
Spouse Information if joint membership desired
Name:
Date of birth:
SSN:
Phone:
Spouse Employment Information
Current employer:
Employer address:
How long?
Work Phone:
E-mail:
Fax:
City:
State:
ZIP Code:
Position:
Hourly     Salary     (Please circle)
Yearly income: $
References
Name
Address
Phone
 
 
 
 
 
 
Children if membership privileges desired
Name and age:
Name and age:
Name and age:
Name and age:
Signatures
I authorize the verification of the information provided on this form as to my credit and employment. I have received a copy of this application.
Signature of applicant:
Date:
Signature of spouse (only for joint membership):
Date:
 

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