MEMBERSHIP SIGNUP Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstLastAddress *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip Code referred Employer/Occupation Membership Email *Phone *Birthdate *Employer/Occupation * Family/Significant Other: Additional membership information for family/significant other living at above address who will be active members, or employee under the business classification. DOB necessary to determine classification level. NameFirstLastRelationshipBirthdatePhoneEmail * Add Remove Membership Classification Check box below for Membership Classification you are applying for.Family Golf ClassificationsJunior FamilyAssociate FamilyAdult FamilySeniorSocial Membership ClassificationsClubhouse SocialSingle Golf ClassificationsJunior SingleAssociate SingleAdult SingleOther Golf ClassificationsNon-ResidentTemporaryStudentCollegiateLimited PlayBusinessIf you were referred by a current member please list them hereSignature Clear Signature Application DateAre you applying with a special?FALLBOBONot applying with specialPlease select oneSend Membership Request Cortland's Premier Golf & Private Club Location Cortland, New York Phone (607) 753-3336 Email info@cortlandcountryclub.com
