Membership Application

Personal Information
Name *
Home Address *
City *
State *
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Zip *
Home Phone
Cell Phone
Date of Birth *
Employer or Business Name
Occupation & Title
Name of Spouse if Applicable
Home Phone
Cell Phone
Date of Birth
Employer or Business Name
Occupation & Title
Email Addresses for Club Correspondence *
Dependent Information:
Name
Date of Birth
Gender
Charging Privileges
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  • Yes
  • No
Name
Date of Birth
Gender
Charging Privileges
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  • Yes
  • No
Name
Date of Birth
Gender
Charging Privileges
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  • Yes
  • No
Name
Date of Birth
Gender
Charging Privileges
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  • Yes
  • No
Affiliations:
Name
City
Length of Membership
Fauquier Springs Member reference
Where did you hear about Fauquier Springs?
Membership Information:
Category:
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  • Full Golf Family
  • Full Golf Individual
  • Full Corporate
  • Full Corporate Associate
  • 29 & Under
  • 30-39
  • Legacy 29 & Under
  • Legacy 30-39
  • Out of Town
  • Social Family
  • Social Individual
  • Social Corporate
  • Social Corporate Associate
  • Clubhouse Family
  • Clubhouse Individual
I would prefer my monthly statements to be:
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  • Mailed
  • Emailed
Applicant’s Signature