WCC Candidate Fact Sheet | Wilmington Country Club

Candidate Fact Sheet

Full Name
Spouse's Name
Home Address
Home Telephone, Work and Cell Phone
Email
Was the candidate a former member, please state classification and period of time
How long has the candidate lived in the area?
Previous residence(s)
Date of Birth
Place of Birth
Educational Record
Please list the names of your High School, College, Graduate School as well as degree title and year graduated
Fraternity / Sorority / College Clubs
Please list your Business / Professional (Office and Position Held)
Business Name, Address and Telephone
Other Club Memberships (former and current - include positions held)
Community Activities (former and current - include positions held)
Is the Candidate
- Single
- Married
- Divorced
- Widow(er)
Will spouse be applying for Associate Membership?
- Yes
- No
If married, provide maiden name of wife or husband's full name
Date of Birth
Email Address
Cell Phone
Educational Record
Please list the names of your High School, College, Graduate School as well as degree title and year graduated
Please list your Business / Professional (Office and Position Held)
Business Name, Address and Telephone
Will children be applying for Membership?
- Yes
- No
Candidate's Children
Please list their name(s) and date(s) of birth
Electronic Signature
Candidate: Please type your name and date below