Member Application

Full Name(*)

Please let us know your name.

Date of Birth(*)

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Street Address(*)

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City(*)

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State(*)

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Zip Code(*)

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Cell Phone(*)

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Home Phone(*)

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Email Address(*)

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USGA GHIN Member #

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For information on all Membership options click here

Membership Type(*)

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Regular Dues ($)

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If applying for a Family Membership:

Spouse's Name

Spouse Email

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Spouse Cell Phone

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Spouse Date of Birth

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How Many Children Under the Age of 22? Please list their names and date of birth.

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If applying for a Corporate Membership:

Name of 1st “Full Membership” Member

1st Full Member Email

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1st Full Member Cell Phone

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Name of 2nd “Full Membership” Member

2nd Full Member Email

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2nd Full Member Cell Phone

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Name of “Limited Membership” Member

Limited Member Email

Please let us know your email address.

Limited Member Cell Phone

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Agreement

I hereby apply for membership in Cohasse Country Club. If elected I agree to abide by all the rules, by-laws, and regulations of the club. I understand that the Board of Governors reserves the right to accept, reject or revoke all applications and memberships. I understand that the Board of Governors has the right to change the rules and regulations in the best interest of the club

I agree(*)

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