NCR Country Club
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Membership Process


Membership subject to the stated application process.


Membership Application
NCR Country Club
4435 Dogwood Trail Dayton, Ohio 45429
Office: 937/299-3571



I wish to apply as a candidate for membership in NCR Country Club.

By completing this application, I represent and warrant to NCR Country Club
that the information submitted is true and accurate.

I agree to provide payment for the initiation fee and appropriate dues billed following
the completion of my membership process.

Please choose one membership option:

 Golf
 Young Executive
 Social Non-Resident
 Applicant 
Name:

Years of Residence in Dayton Area:
 Birth Date:
Street Address:
City:
State:
Zip:
Home Phone:
Cell Phone:
Email:

Profession / Occupation:
Employer:


 Applicant's Spouse 
 Spouses Name:

 Birth Date:
 Email:
 Cell Phone:
 Profession / Occupation:
 Employer:


 Additional Information

I am, or have been, a member(s) in good standing in the following social clubs:

Clubs & Dates
Please List the name and date of birth of children under the age of 25 and living at home: 
Please list any current NCR Country Club Members you may know: 
NON-MEMBER PERSONAL REFERENCES
Personal References are required by the Board of Trustees for consideration
Reference 1
First Name:
Last Name:
Home Phone:
Business:
Address:
City:
State:
Zip:
How long acquainted:
What is your association:
Reference 2
First Name:
Last Name:
Home Phone:
Business:
Address:
City:
State:
Zip:
How long acquainted:
What is your association:
Reference 3
First Name:
Last Name:
Home Phone:
Business:
Address:
City:
State:
Zip:
How long acquainted:
What is your association:
Completed application must be accompanied by letters of recommendation from
TWO (2) current members of NCR Country Club.

By submitting this application, you agree to abide by NCR Country Club's rules and regulations. 
By submitting this application you are committing to the fiscal year, through April 1. 

An automatic email replay will come when the application has successfully been submitted.
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