Membership Application Click here to download PDF. * indicates required field CONTACT INFORMATION Name(s):* Street Address:* City:* State:* Zip Code:* Home Phone: Cell Phone:* Email:* MEMBERSHIP RATES EAGLE MEMBERSHIP: (Annual Fee) Couple: $1,050 Single (28yrs+): $625 Single (18-27yrs): $350 Junior (＜17yrs): $100 New Member Discount: -$100 BIRDIE (TWILIGHT) MEMBERSHIP: (Annual Fee) Couple: $750 Single (28yrs+): $425 Single (18-27yrs): $300 Junior (＜17yrs): $100 Season Range Pass: $75 New Member Discount: -$100 PINEWOOD/INSHALLA COUNTRY CLUB COMBO PASS: Available for Eagle and Birdie Memberships Only (Includes Cart Use): Couple: $375 Single: $250 CART FEES (Eagle and Birdie Memberships Only): Couple Seasonal Cart: $550 Single Seasonal Cart: $375 METHOD OF PAYMENT Total Amount Due: Payment Method: Cash Check Enclosed is my payment in the amount of: $ Credit Card Please charge my card in the amount of: $ Card Type: Visa MasterCard Discover Cardholder’s Name: Billing Address: Card Number: Exp Date: Security Code: OFFICE USE ONLY First Payment Date: Amount Paid: Balance Amount Due (if applicable)*: Balance Payment Date: Amount Paid: Notes: *All balances are due in full by April 15, 2019 Any payments after that date will be charged $50 more per membership category except for seasonal cart fees. If not paying in full by April 15th, a $100 deposit will be taken to reserve your membership with balance due by July 1, 2019. CAPTCHA Code:*
