Date__________
Member Name____________________________________DOB_______________
Spouse Name_____________________________________DOB_______________
Address____________________________________________________________
City_____________________State______________________Zip Code_________
Home Phone____________Work Phone____________Cell Phone_____________
Email Address_______________________________________________________
2014 Membership Dues
Season Membership Dues Seasonal Cart
• 35 and under _____650 _____550
• Single _____800 _____550
• Senior (63+) _____650 _____550
• Couple _____1375 _____550 (per person)
• Couple – Senior _____1250 _____550 (per person)
• College Student _____350 _____NA
• Junior _____125 _____NA
Monthly Membership
• Single _____150 _____NA
• Senior _____130 _____NA
• Couple _____275 _____NA
• GHIN Handicap _____35
• Driving Range _____185
• Total Due_______________________
*College Membership is full time student age 22 and under
*Junior Membership is age 19 and under
*Dues paid by February 28 receive 8% clubhouse / pro shop credit of amount paid
*Dues paid by March 23 receive 4% clubhouse / pro shop credit of amount paid
P.O. Box 1485, Lanesboro, Ma 01237
Phone: 413-445-5584
www.skyline-cc.com
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