DEVON GOLF & CONFERENCE CENTER   ( 780 ) 987 - 3477

2012  Membership Application

________________________________________                     ________

_______ / ______ / ______

month        day           year

Member Name

Member Number

Date Of Birth

___________________________________________

_____________,

___________

________ - ________

Mailing Address

City

Prov.

Postal Code

( _____ ) _______ - _______                          ( _____ )_______ - _______                   _________________________

Home Phone Number                                       Business Number                                   E-Mail Address

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

OPTION A -  FULL PAYMENT  ( On Or Before Midnight of …)

CATEGORY

BY JAN. 15

BY FEB. 15

BY MAR. 15

APR. 15

MAY. 15

Full Membership

$1,400.00

$1,450.00

$1,510.00

$1,575.00

$1,595.00

Associate Membership

$1,110.00

$1,155.00

$1,220.00

$1,275.00

$1,330.00

(Mon.-Fri. excluding Holidays)

Student

$905.00

$945.00

$1000.00

$1,055.00

$1,100.00

Junior   11 - 17

$290.00

$305.00

$325.00

$345.00

$365.00

Jr. Junior   10 & Under

$210.00

$230.00

$245.00

$260.00

$270.00

G.S.T. Included

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OPTION B  -   Payment Plan:

MUST BE RECEIVED ON OR BEFORE JAN 14, 2012

Full Member

Associate Member

4 Payments of

$362.50

4 Payments of

$288.75

PAYMENT PLAN:

Payment must be received before midnight January 14, 2012.

Four equal post dated cheques Jan 15, Feb 15, Mar 15, & Apr 15th, 2012

or by credit card with payments taken out on  Jan 15, Feb 15, Mar 15, & Apr 15th, 2012

for the amount of:

Full Membership     $ 362.50  X  4  =  Total Price $ 1450.00

Associate Member     $ 288.75  x  4  =  Total Price $ 1155.00

G.S.T is included

Payments Based on February Prices Only

Club Services (eg. Club Storage, Lockers and Power Carts) must be paid in full.

You can not divide these payments in four.

SEE REVERSE FOR MEMBER SERVICES AND PAYMENT OPTIONS

Membership Services

Locker Rental & Club Storage

If you wish to add your locker, club storage or power cart passes to your payment these must be paid in full.

They May Not be divided into monthly payments

Small Locker

# _________

$25.00

Adult Club Storage

$80.00

Club & Pull Cart Storage

$140.00

Large Locker

# _________

$35.00

Junior Club Storage

$60.00

Power Cart Passes

(10) 18-Hole Round Pass

$220.00

(40) 18-Hole Round Pass

$750.00

(20) 18-Hole Round Pass

$400.00

Single User Unlimited Use

$960.00

G.S.T. Included

Please Check Which Division You Will Be Participating In.

Mens

Ladies

Seniors must be 50 or Older

Senior Men

Senior Ladies

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METHOD OF PAYMENT

Cheque

Debit Card

Cash

Credit Card  ________

#

# _________ - _________ - _________ - ________

Exp. Date

_____ / _____

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I hereby agree with all of the terms and conditions set out by the Policies and Bylaws of the Devon Golf & CC

___________________________________________

___________________________

MEMBER'S SIGNATURE

DATE

!!!   ALL MEMBERSHIP DUES ARE NON - REFUNDABLE   !!!

Send All Cheques Along With This Application Form To

DEVON GOLF & C.C.      1130 RIVER VALLEY      DEVON, AB    T9G 1Z3

PHONE: (780) 987 3477                      FAX: (780) 987 3300

E-MAIL: admin@devongolf.ca            WEBSITE: www.devongolf.ca

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( OFFICE USE ONLY )

Card Given

Fairway

Teeway

Access

S/A

Exel