MEMBERSHIP CHANGE REQUEST
This form is to be used only during April or October
First Name:
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Last Name
*
Phone
Email
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Spouses' Name
My family intends to:
Membership Plans
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Resign our family's Membership
Transfer from Active to Senior Membership (permitted after 10+ years as Active Members, at least 1 spouse 55+ years old, no children under 18)
Transfer from Senior to Super Senior Membership (permitted after 25+ years of membership, at least 1 spouse 70+ years old, no children under 18)
Transfer from Super Senior to Honorary Membership (permitted after 30+ years of membership, at least 1 spouse 75+ years old.)
If resigning, what are the reasons? If not resigning, enter n/a.
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If requesting change of class, enter DOB of qualifying spouse, and
Month/year joined club, and
DOB of youngest child
