THE VILLAGES PITTSBURGH CLUB

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: $10.00 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.)

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

Treasurer:  Amount received   _______        Date:  _____________