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Individual Application.

THE ESTABLISHMENT


MEMBERSHIP APPLICATION

I am interested in acquiring a membership in The Establishment, a premier business and social club (“the Club”) owned and operated by 1898, LLC, a Florida limited liability company (“Company”). I am providing the following information for membership in the Club. Upon completion and review of this application, I acknowledge and agree that the Club makes no representations or guarantees whatsoever as to my acceptance for membership in the Club.

    Personal

    Applicant's Name:

    Birth Date:

    Email Address:


    If married, please fill out the Spouse's information below

    Spouse's Name:

    Birth Date:

    Email Address:

    Anniversary:

    Local Residence:

    Number:

    Street:

    City/State:

    Zip:

    Other Residence:

    Number:

    Street:

    City/State:

    Zip:

    Mailing/Billing Address:

    Number:

    Street:

    City/State:

    Zip:

    Local Residence Telephone:

    Spouse's Phone Number:

    Cell Phone Number:

    Business

    Applicant's Company Name:

    Title:

    Nature of Business or Profession:

    Business Address:

    Telephone:

    Years in Present Employment:

    Spouse's Company Name:

    Title:

    Nature of Business or Profession:

    Business Address:

    Telephone:

    Years in Present Employment:

    Organizations, Boards, Affiliations

    Please list all memberships in other business, professional, civic and fraternal organizations:

    Organization Name




    Years of Involvement




    Position(s) Held




    Term of Position(s)




    Other Club Relations

    1. Name of Club:

    Contact:

    Address:

    Telephone:

    Type of Membership:

    Year Accepted:

    Present/Former Member:

    2. Name of Club:

    Contact:

    Address:

    Telephone:

    Type of Membership:

    Year Accepted:

    Present/Former Member:

    Referring Member and Sponsor Information

    Referring Members and Sponsors, please review the Sponsorship Information found in the Rules and Regulations for the Club before
    signing below.

    Referring Member Name:

    Years Known:

    Sponsor Name:

    Years Known:

    Sponsor Name:

    Years Known:

    Applicant's Authorization

    Yes I acknowledge, accept and understand that my membership is contingent upon approval by the Club, which approval shall be at the sole
    discretion of the Club. If accepted for membership, the Club will send the applicant a letter notifying him/her of their acceptance for
    membership and will provide the applicant a Membership Agreement. I acknowledge and agree that membership in the Club is not
    effective and binding until the Membership Agreement is executed by the Club and all membership fees are paid in full.

    If accepted for membership in the Club, I further agree to pay all required membership fees, monthly dues/fees and any charges incurred on
    my membership account with the Club. I acknowledge and accept that membership fees and monthly dues/fees are subject to change at the
    sole discretion of the Club. I further acknowledge, accept, and understand that I am personally liable and responsible for all financial
    obligations relating to my membership in the Club, including all fees and charges associated with my immediate family members and
    guests who utilize the Club

    If my Membership Application is approved, I agree to observe and be bound by this Membership Application, the Membership Plan and the
    Rules and Regulations of the Club.

    I acknowledge, accept, and understand that the information stated herein is true, and any false statement or false information contained
    herein may be grounds for denial of my application or for termination of my membership after acceptance.