MENU MEMBERSHIP APPLICATION 25 Kings Highway South Westport, Connecticut (203) 221-3280 Membership Application Click to Download PDF Printable Version I hereby enter my application for membership in Birchwood Country Club. I agree, if accepted as a member, to accept and abide by its by-laws, rules and regulations and to pay, when due, all financial obligations which can include operating and capital assessments. Name of Primary Candidate Name of Secondary Spouse Candidate Date Sponsor Sponsor Type of Membership Regular Racquets Associate House Applications will not be considered unless completed in full. Dues and similar payments are not deductible or considered charitable contributions. PRIMARY CANDIDATE Full Name of Primary Candidate Date of Birth Place of Birth Residence (A) and Dates Primary Telephone No. Residence (B) and Dates Secondary Telephone No. Cell Phone No. Email Address Business Firm Name Business Address Business Telephone No. Dates Associated with Firm Nature of Business Occupation Schools Attended and Dates Brief Outline of Career Names of Children, DOB, Residence Parents' Names Full Names of Brothers and Sisters (Including place of residence) Previous Residences and Dates Please list any current or prior club memberships and dates Have you ever been denied admissions to any club and if so why? Community Participation Charitable Contributions (List only organizations to which you contribute on an ongoing basis) Special Interest and/or Hobbies SECONDARY SPOUSE CANDIDATE Full Name of Secondary Candidate Date of Birth Place of Birth Residence (A) and Dates Primary Telephone No. Residence (B) and Dates Secondary Telephone No. Cell Phone No. Email Address Business Firm Name Business Address Business Telephone No. Dates Associated with Firm Nature of Business Occupation Schools Attended and Dates Brief Outline of Career Names of Children, DOB, Residence Parents' Names Full Names of Brothers and Sisters (Including place of residence) Previous Residences and Dates Please list any current or prior club memberships and dates Have you ever been denied admissions to any club and if so why? Community Participation Charitable Contributions (List only organizations to which you contribute on an ongoing basis) Special Interest and/or Hobbies BOTH CANDIDATES Reference: (Include length of time known for all references) Birchwood Members Additional Information Once you have submitted your application the following statement will be present on the top of the application: "You have already completed this form. You may review your answers below." If you do not see this confirmation, please resubmit or contact us at 203-221-3280.