Copper Mill Golf Club
Online Membership Application Form

To make applying for golf membership at Copper Mill Golf Club as easy as possible, we have installed this online form on our web site so that you can fill it in with your information and send it to us for processing.  Please be sure to fill in all applicable information and double-check that the information you provide is correct so that we can process your application as quickly as possible.

If you have any questions, please contact us via e-mail here or call our office at 225.658-0656

SECTION 1:  PERSONAL INFORMATION:

Select Only One:  Mr.        Mrs.        Ms.        Miss        Dr.

First Name

Middle Initial

Last Name

Home Street Address

City

State                                                                             
               

ZIP Code

International Applicants Only:  Please type your mailing address in the box below

Home Telephone (Area Code + Number)
+ -

Social Security Number
- -

E-mail Address

SECTION 2:  EMPLOYMENT INFORMATION:

Employer Name

Work Mailing Address

City

State                                                                                                
                 

ZIP Code   

Work Telephone (Area Code + Number)
 + -

Work Fax (Area Code + Number)
 + -

Occupation/Type of Business

Title                                                    
           

Years at This Position

Mail my Copper Mill club billings to my (select only one):   Home Address        Business Address

Mail all other correspondence to my (select only one):  Home Address         Business Address

SECTION 3:  SPOUSE INFORMATION (if applicable):

If not married, please check this box and continue to Section 4 (if applicable) or Section 5

Spouse's Name (select only one):  Mr.        Mrs.        Ms.        Dr.

First Name

Middle Initial

Last Name

Employer (if applicable)

Work Mailing Address

City

State

ZIP Code

Work Telephone (Area Code + Number)
 + -

Work Fax (Area Code + Number)
 + -

Occupation/Type of Business

Title

Years at This Position

SECTION 4:  DEPENDENT INFORMATION (if applicable):

If no dependents, please check this box and continue to Section 5

For Family Membership, please provide the following information for your dependents:

Dependents are defined as children who are under the age of twenty-one (21) and are either a) living in the member's home or b) attending school on a full-time basis.

First Name Last Name Birth Date (mm/dd/yy) M F
1

2

3

4

SECTION 5:  REFERENCES:

Please list two other clubs or organizations you are a member of:

1.  Name of club or organization

City                                                                            

State

Years you were a member       
                       

Presently a member?    Yes     No

Are you a member in good standing?   Yes     No

If no, please explain

 

2.  Name of club or organization

City                                       
                                     

State

Years you were a member           
                   

Presently a member    Yes        No

Are you a member in good standing?   Yes        No

If no, please explain

SECTION 6:  ADDITIONAL INFORMATION FOR CORPORATE MEMBERSHIP APPLICANTS:

If you are applying for a Corporate Membership, please provide the following information (Individual or Family Membership applicants should skip to Section 7):

Business/Firm Name

Officer's Name (person who will serve as the account contact)

Mailing Address

City

State                                                            

ZIP Code                    

Work Telephone (Area Code + Number)
 + -

Work Fax (Area Code + Number)
 + -

E-mail Address

For corporate membership aaplications, please list any additional designees that you wish to have membership privileges (each designee is required to complete and application and is subject to approval by Copper Mill Golf Club).

First Name Last Name Title/Position at Business
1

2

3

4

SECTION 7:  ACCEPTANCE OF TERMS AND CONDITIONS:

NOTE:  Please read the terms below and double check all information before submitting this form
as incorrect or incomplete information will delay processing.

By submitting the information provided above, you warrant that all of the information is true and accurate and you further acknowledge that you are providing your digital "signature" for this application for membership at Copper Mill Golf Club.  For Corporate applications, the person listed as the officer of the business warrants that he or she is duly authorized by the business to provide said information.  All applicants must first read the following terms and conditions or membership at Copper Mill and agree thereto before clicking the "Submit" button below (additional information may be requested by the Club prior to issuing membership):

 

Summary of Membership Terms and Conditions:

                Copper Mill Golf Club (the Club) will offer memberships to the first 300 approved applicants.  A membership review committee will screen each applicant for membership and pass their general recommendations over to the management of the Club.  Each member will be required to follow and uphold all rules and regulations set forth by the Club.  The Club retains all equity and reserves the right to amend any and all rules and regulations at the Club as they deem necessary. The Club also reserves the right to suspend any memberships should there be sufficient reason to do so.  Membership suspensions will ring with it a refund of initiation fees.  The membership review committee will have final decisions in the matter of suspensions.

1. Approved members will have all the rights and privileges set forth by the Club pertaining to the type of membership purchased.
2. Memberships are not automatically transferable.  A member wanting to transfer his/her membership to a third party may do so only after that third party has been approved for membership by the membership review committee and a $500.00 transfer fee has been paid to the Club.
3. Members wishing to go inactive may do so by first notifying the Club in advance with a 30-day written notice. There will be a $10.00 monthly inactive fee and a $500.00 reinstatement fee once re-activation is desired.  It should be noted that inactive memberships may be transferred  provided the $500.00 transfer fee has been paid and the prospective new member has been approved for membership.
4. Members wishing to resign from the Club must submit a written notice of resignation to  the Club 30 days in advance.  All accounts must be paid in full and brought current before resignation is recognized by the Club.   Resignation will not bring with it any refund of initiation fees paid to the Club.
5. All memberships, other than Corporate memberships and Individual memberships, extend privileges at the Club to a married spouse and their unmarried children under the age of 21 or full-time students living in the same household.
6. The above listed policies are in summary.  A complete policy hand-book will be issued 60 days prior to the Club's opening.
7. Approved members have no ownership interest or equity or any other property interest in the Club or facilities at the Club. The Club retains all equity and ownership interest in all properties and facilities  at Copper Mill.
8. All charges (dues, fees, food, beverage, merchandise, services and other charges) of the Club charged to the members club account will be billed monthly and shall be due upon receipt and shall be deemed delinquent if not paid within thirty (30) days after the date of the monthly statement..
9. All past due bills will accrue a late fee each month of at least ten dollars ($10.00) and/or interest at the maximum, non-usurious rate permitted by law from the date of the statement until paid in full.
10. Any and all reasonable attorneys fees, investigation fees and other cost incurred in connection with the collection of delinquent accounts shall be paid by the undersigned.
11. The undersigned authorizes the disclosure and release of any information to the Club that may be deemed necessary to process membership approval. This information may include such items as credit reports, employment characterizations, banking relations, etc.