APPLICATION FOR MEMBERSHIP

Which membership are you ___ PROPRIETARY ___ CORPORATE REPRESENTATIVE

applying for: ___ PLAYING GUEST ___ HONORARY ___ ASSOCIATE MEMBER

PLEASE TELL US ABOUT YOURSELF

Name: Nickname:
(Last Name) (Given Name) (Middle Name)
TIN No.: _________________ Passport No.: __________________ Place & Date of Issue: ____________
Highest Educational Attainment: ________________________ Schools Attended:_____________________
Course/Major: ______________________________________ Year: ____________________
Occupation: ____________________________
Place of Birth: Date of Birth: Citizenship:
Parentage: Father: Mother:
Civil Status: If Married, Name of Legitimate Spouse:
Occupation (Spouse): _____________________________ Date of Birth (Spouse): ____________________
Residence Address:
Tel. No. Mobile No. E-mail Address*:
How long have you been playing golf?
What’s your present handicap?
Membership in other Clubs (if any):
PLEASE TELL US ABOUT YOUR WORK
Name of Company:
Line of Business:
Position:
Business Address:
__________________________________ ZIP Code: _________ Nearest Landmark: __________________
Tel. Nos. _________________________________ Fax No. ______________________________________
*- Billing Statement will be sent thru email.

Dependents other than spouse: Unmarried children under 21 years of age are eligible for privileges under this
membership. (For playing guests, only two (2) children are eligible. Please check who among your dependents
will play.) Single dependents of proprietary members who are 21 years old (on the birth date) up to 30 years old
may apply for an associate membership.
NAME SIGNATURE DATE OF BIRTH
(Please submit Birth Certificate)
______________________________ ______________________ __________________________
______________________________ ______________________ __________________________
______________________________ ______________________ __________________________
______________________________ ______________________ __________________________
(If additional space needed use extra sheet)
PERSONAL REFERENCES:
NAME RELATIONSHIP ADDRESS / TEL. NO. & MOBILE NO.
__________________________ _____________ _____________________________
__________________________ _____________ _____________________________
Do not leave spaces blank. Write N/A if not applicable.

VGCCI MEMBERSHIP APPLICATION FORM 2018

 UNDERTAKING

I hereby certify that all information given in this application is true and correct. I understand that non-
disclosure/misrepresentation/falsification of information as herein required shall be a ground for the disapproval of
my application, immediate termination of my membership if approved, and/or legal action against me. By filling up
and submitting this application form, I hereby agree that my personal data provided in this form may be collected,
used, processed and disclosed by the Club for purposes of processing my application for membership,
dissemination to members of information on latest happenings in the Club, sending of billing statements, Club
News, bulletins, emergency and general announcements, special course conditions, special events, promotional
offers and other relevant information of the Club via SMS (Text Messaging), e-mail or other electronic messaging
facilities, in accordance with the Data Privacy Act of 2012 and its implementing rules and regulations. In respect of
disclosure, I understand that the Club may disclose my personal data to third parties where necessary for the
above-stated purposes.

I agree to abide by the By-Laws and Rules & Regulations of Valley Golf & Country Club, Inc., Antipolo City.

By becoming a member of Valley Golf & Country Club, Inc. I hereby declare my willingness to pay service
fee for every round of golf, buy Bingo Social raffle tickets and car stickers and other assessments as part of my
commitment to the club.

_______________________________________ ___________________________________
Applicant’s Authorized Signature Date

Proposer Seconder
(Signature over printed name) (Signature over printed name)
Account No. _____________ Account No. _____________

Note: Both Proposer and Seconder must be Valley Golf & Country Club proprietary members of good standing.
Proposer and Seconder hereby confirm the applicant’s good moral character and guarantee the applicant’s good and
upright conduct within Valley Golf & Country Club.

VGCCI MEMBERSHIP APPLICATION FORM 2018