LAKE RIPLEY COUNTRY CLUB

No initiation fee at this time

Name: _____________________________ 

Name: ___________________________

Email: ______________________________

Email: __________________________

Children (age 19 and under): Include their names and ages.
____________________________________________________________  

Home Address: ________________________________________________________

Billing Address: ________________________________________________________

City: ______________ State: _________ Zip: _______________

Telephone (Home): ______________ (Cell): __________________ 

Telephone (Home): _______________ (Cell): _________________

Employment: ______________ Company: _______________________

Company Address: ______________________________________________________

Recommended by: _______________________________________________________

Former Club Membership: _________________________________________________

IMPORTANT PLEASE READ: The Lake Ripley Country Club Board of Directors will review the applications and accept new members. You will be notified by mail if you have been accepted and will be sent a dues statement.

Applicant Signature: ________________________________________

Return to: Lake Ripley Country Club
PO Box 31
Cambridge, WI 53523