Membership Registration


RESIDENT MEMBERSHIP: Owners who reside in The Villages on a full-  or part-time basis

GUEST MEMBERSHIP: Renters who are residing in The Villages for a maximum of 4 months


Name: (1)_____________________________________________________


Name: (2)_____________________________________________________


Address:  ______________________ Village:_______________   Zip Code:____

Check one:   I/we OWN ___  and reside in The Villages     Year round ___     Seasonally  ___

                    I/we RENT ___       Dates of Rental Term: _____________________

Phone No:  ______________


E-Mail Address:  _________________________

------------------------INFORMATION TO APPEAR ON BADGE--------------------------


Name: (1)____________________________ Pgh. Location (1) __________________


Name: (2)____________________________ Pgh. Location (2) __________________

Membership – Write check payable to THE VILLAGES PITTSBURGH CLUB

Owners: $15.00 each (includes badge with magnet closure and gold trim and Dues.  (Note:  If for medical reasons you would prefer  a pin rather than magnet closure, please initial here: ______ )

Renters: $5.00 each (covers a maximum of 4 months’ membership with a paper guest membership card.)


Member:  Please initial to indicate accuracy of above information:  ______________

Treasurer:  Amount received   _______        Date:  _____________