DECLARATION OF MEMBERSHIP INTEREST STATEMENT

High Pointe Golf Club is an invitation-based national golf club. Completing this Declaration is required for membership consideration. Sponsorship from a member is required. Without sponsorship, please provide two (2) reference letters from the golf professional and/or club manager at your current club(s).

PERSONAL INFORMATION

FIRST NAME*

LAST NAME*

EMAIL*

PHONE NUMBER*

DESIRED MEMBERSHIP CLASS*

PREFERRED PHONE CONTACT METHOD*

CURRENT HANDICAP*

GHIN NUMBER*

STREET ADDRESS (PRIMARY)*

CITY*

STATE/REGION*

POSTAL CODE*

DATE OF BIRTH*

ALMA MATER*

LINKEDIN HANDLE*

INSTAGRAM AND/OR FACEBOOK HANDLE*

SHIRT SIZE

SHOE SIZE

BELT SIZE (EVEN SIZES ONLY)

PREFERRED INITIALS (AB, ABC, A B, etc.)

PREFERRED BEVERAGE OR COCKTAIL

OTHER ADDRESS/SEASONAL HOME*

CLUB COMMUNICATION ADDRESS*

PROFESSIONAL INFORMATION

COMPANY NAME*

ROLE/TITLE*

BUSINESS EMAIL

WEBSITE URL

YEARS WITH CURRENT EMPLOYER

BANKING RELATIONS

NAME OF INSTITUTION*

LOCAL BRANCH ADDRESS

PRIMARY BANK CONTACT INFORMATION

GOLF AFFLIATIONS

(1) CLUB *

(2) CLUB

(3) CLUB

(4) CLUB

PROFESSIONAL and/or GOLF REFERENCES

(1) NAME + RELATIONSHIP*

(1) REFERENCE EMAIL ADDRESS*

(1) REFERENCE PHONE NUMBER*

(2) NAME & RELATIONSHIP*

(2) REFERENCE EMAIL ADDRESS*

(2) REFERENCE PHONE NUMBER*

(3) NAME & RELATIONSHIP*

(3) REFERENCE EMAIL ADDRESS*

(3) REFERENCE PHONE NUMBER*

SPONSORING MEMBER REFERENCES

*SHOULD YOU NOT HAVE THREE SPONSORS AFFILIATED WITH HIGH POINTE, PLEASE PROVIDE TWO LETTERS OF REFERENCE FROM THE GOLF PROFESSIONAL OR GENERAL MANAGER AT YOUR CURRENT CLUB(S).

SPONSORING MEMBER #1

RELATIONSHIP TO #1

YEARS KNOWN #1

SPONSORING MEMBER #2

RELATIONSHIP TO #2

YEARS KNOWN #2

SPONSORING MEMBER #3

RELATIONSHIP TO #3

YEARS KNOWN #3

Q & A

HOW DID YOU HEAR ABOUT HIGH POINTE?*

WHY ARE YOU INTERESTED IN MEMBERSHIP AT HIGH POINTE?*

DO YOU KNOW ANYONE AFFILIATED WITH HIGH POINTE? OR OTHERS INTERESTED IN MEMBERSHIP? IF SO, WHO?

BRIEFLY DESCRIBE YOUR MOST MEMORABLE GOLF EXPERIENCES.

HOW OFTEN DO YOU GOLF?*

HOW OFTEN DO YOU EXPECT TO VISIT HIGH POINTE?*

HOW OFTEN DO YOU HOST CLIENTS OR BUSINESS ASSOCIATES FOR GOLF?*

PREFERRED MODE OF PLAY - 1st CHOICE*

PREFERRED MODE OF PLAY - 2nd CHOICE*

PREFERRED MODE OF PLAY - 3rd CHOICE

IF YOU COULD BRING ONE THING TO HIGH POINTE, WHAT WOULD IT BE? THIS COULD BE AN EMPLOYEE, A POLICY FROM ANOTHER CLUB, A FOOD OR BEVERAGE ITEM, ETC.

HAVE YOU BEEN SUBJECT TO ANY PAST OR PENDING ACTIONS (I.E. SUSPENSIONS, LEGAL JUDGEMENTS, ETHICS REPRIMANDS, ETC.) AT ANY CLUB/ORGANIZATION WHERE YOU HAVE BEEN AFFILIATED? IF SO, PLEASE EXPLAIN.*

DO YOU OWN OR RENT A HOME WITHIN A 100-MILE RADIUS OF HIGH POINTE GOLF CLUB (5555 ARNOLD RD. WILLIAMSBURG, MI 49690)?*

ACKNOWLEDGEMENTS

Upon signing this information statement, I authorize the disclosure and release of information requested by HIGH POINTE for investigating my qualifications for membership, including without limitation, law inforcement records and obtaining any credit reports(s) reflecting any credit history, and shall hold HIGH POINTE harmless from any and all such acts. I further authorize those persons or entities set forth in this statement to furnish all information requested by HIGH POINTE and agree to hold HIGH POINTE harmless from any and all such acts. I understand that membership at HIGH POINTE is by invitation only and in order to acquire a membership at HIGH POINTE, I must be invited for membership. Membership is contingent upon approval by HIGH POINTE and approval shall be granted at its sole discretion. I acknowledge that each membership will be in the name of one individual in accordance with the Membership Plan, Rules and Regulations of HIGH POINTE and HIGH POINTE'S guest policies. All information contained within this information statement will be kept confidential by HIGH POINTE, except as otherwise required by law.

I HEREBY SUBMIT THIS COMPLETED DECLARATION OF MEMBERSHIP INTEREST TO HIGH POINTE GOLF CLUB. I HAVE READ, UNDERSTOOD, AND ACCEPT THE HIGH POINTE GOLF CLUB MISSION STATEMENT.

CHECK THIS BOX "YES" OR "NO" THAT YOU HAVE READ AND AGREE WITH THE ACKNOWLEDGEMENT*

TYPE YOUR FULL NAME/DATE AS SIGNATURE AGREEING TO ABOVE*

Upon receipt of a completed statement, the Club will review all data points, contact references and could engage a third-party for a background check. Declaration Statements without member sponsorship or reference letters will not be consider. Once completed information is reviewed qualified candidates will be contacted directly for next steps. Applicants, at the sole discretion of the Club, may be approved or denied without explanation.