入会申请书

入會申請書

APPLICATION FORM

I wish to accept invitation for M embership and provide the foll owing information for the C lub’s use in processing my Membership.本人愿意接受邀请，成为贵俱乐部会员，并提供下列资料以作会员登记之用。

□Mr 先生□Miss小姐□Ms女士□Mrs太太□Dr博士□Other其他Name (Surname firs t)姓名（请先写姓氏）：

Date of Birth 出生日期：Wedding Anniversary 结婚记念日：

Nationality国籍：ID/ Passport Number身份证/护照号码：

Residential Address 住址：

Home Phone 住址电话：Post Code邮政编码：

Marital S tatus 婚姻状况：□ Single未婚□ Ma rried已婚□O th er其他

Company Name 公司名称：

Company Address 公司地址：

Type of Business 业务性质：Post Code邮政编码：

Length of Employment 任职年限：（years）Position 职衔：

Business Phone 公司电话：Fax 图文传真号码：

E-mail Address 电子邮件：Mob ile Phone 移動電話：

Secretary/Assistant Information秘书/助理资料

Secretary/Assistant’s Name 秘书/助理姓名：Contact Phone 聯系電話：

E-mail Address 电子邮件：Fax图文传真号码：

Spouse Information配偶资料

□Mr 先生□Ms 女士□Mrs太太□Dr博士□Other其他

Spouse’s Name (As desired on Membership Card) 配偶姓名（印于会员卡上）：

Date of Birth 出生日期：

Nationality 国籍：ID/Passport Number 身份证/护照号码：

Company Name 公司名称：

Company Address 公司地址：

Type of Business 业务性质：P ost Code邮政编码：

Length of Employment 任职年限：（years） Position职衔：

Business Phone公司电话：Fax图文传真号码：

E-mail Address电子邮件：Mobile Phone移动电话：

Dependent Information子女资料

Name(s) (U nder 21)：Date of Birth：Gender：Ch arge Privileges (above 8)：姓名（21岁以下）：出生日期：性别：签帐特权（8岁以上）：

Membership Information会员资料

My Membership is本人之会籍为：

□Individually owned个人□ Corporate H older公司主会籍□ Corporate A dditional公司附属会籍

□Three Year Term三年期□Embassy 大使馆□Honorary 荣誉大使

□Transfer 转让□ Legacy 继承□ Chamber商会

Please Contact me by请通过以下方式和我联系：

Mailing Address信函邮寄至□Home家庭地址□Business公司地址

Billing Address帐单邮寄至□Home家庭地址□Business公司地址

Member Sponsor (if applicable) 会员推荐人（如适用者）：

Club Affiliations & Official Appointments

加盟俱乐部和官方任命

List Clubs（business, Sports, Golf, etc.）yo u hold a Membership in:

请列出您会籍所在的俱乐部（商务、运动、高尔夫等）:

Club Name Location

俱乐部名称地址

A.

B.

C.

Affiliations & Non-Profit Organizations & Official appointments

社会团体和非盈利机构及官方任命

List affiliation s in community relations or other non-profit organizations:

请列出社会团体或其它非盈利机构:

Affiliation & No n-profit Organiz ation Name Location

社会团体和非盈利机构的名称位置

A.

B.

C.

Corporate Membership (If Applicable) 公司会籍（如适用者）

Corporate Memberships are held by a corporation or firm which is considered to be the “Ap plicant” for all purposes. A designee is named by the corporation as the person entitled to use the Membership (“C orporate Designee”). There shall be only one Corporate Designee for each personal Membership Card, but the Co rporate Designee may be changed by the corporation from time to time, subject to the approval of the Club’s Admissions Committee and payment of the redesignation fee (as of the date of change). The Membership Card will be issued in t he name of the approved Corporate Designee.

公司会籍由公司或企业（即申请人）所拥有。公司可提名属下职工（公司被提名人）使用会籍。每个公司会籍只限予某一位公司提名人享用，但经会员入会委员会的批准，公司可随时更改会籍之提名人。转名费用将视转名的时间而定，会员卡上将被印上〔公司被提名人〕的姓名。

As a duly authorized officer of the corpora tio n named, the u ndersigned officer certifies and agrees that s aid corporation is join tly responsible with the Corporate Designee for all dues and charges incurred by its Corporate D esignee and guests.

经上述公司适当授权，以下签字官员证明并同意与上述公司共同负责〔公司被提名人〕及其嘉宾的所有应缴付的月费及其他一切费用。

Authorized Offic er’s Signature a nd Company Chop授权官员签名和公司盖印：

Title 职位：Date 日期：

By-Laws and House Rules 会员章程及俱乐部规则

Member and Corporate Designee (if applicable) agree to confo rm to, and be b ound by the By-laws, and Rules and Regulations of

the Club, as the y may be amended from time to time.

会员及公司被提名人（可适用者）同意遵守俱乐部所订立的会员章程及规则，其内容可随时更改。

Club By-Laws and House Rules have been read, understood, an d accepted.会员章程及俱乐部规则已阅，并了解和接受所阅内容。

Applicant’s Signature 申请人签名Date 日期

For Club Use Only会员部专用

Accepted on behalf of the Board of Governors on由会员入会委员会通过接受邀请（如适用者）：

By 经办人：Title 职位：

Chrono Number 会员编号：Membership Number 会员号码：

Membership Fee入会费：

Redesignation fee/transfer fee会员转名费/会籍转让费：

Copy of Contract to Member on 合约副本交予申请人日期：