FOREST HILLS SWIM CLUB 2015 MEMBERSHIP SHEET FOR NEW MEMBERS Name: __________________________________ Phone #: ____________________________ Address: ________________________________ Email: ______________________________ Please check this box if you DO NOT want your email posted in the pool directory. Email will be used for communicating information and updates relating to the club. ________________________________________ Household Members Name Date of Birth Name Date of Birth You can choose to make three equal installments. Payment Schedule dates: 3/1/15 4/1/15 5/1/14 Regardless of your type of membership, dues need to be paid in full no later than MAY 20, 2015. If interested after this date, Please contact our membership director for options. New Member please complete: Referred by: Member name (Maximum of two)___________________________ _____________________________________________________________________________________________ Please return the upper portion of this sheet with your first payment Membership type Family Single Couple Retired Single Retired Couple Initiated Dues $610 $410 $545 $345 $400 Reduced Initiation $400 $400 $400 $400 $400 Sub-Total $1010 $810 $945 $745 $800 Total with sales tax $1079 $865 $1009 $796 $854 Non-Initiated Dues Total with sales tax $750 $483 $620 $415 $470 $801 $516 $662 $443 $502 An Initiated membership type means that you have paid a one – time initiation fee of $500.00 plus tax. If you pay your th membership in full by May 15 , 2015, your initiation fee is $400.00 plus sales tax. Or you can pay the non-initiated rate for 4 th consecutive years and on the 5 year you would pay the initiated rate Make Checks Payable to: Forest Hills Swim Club Please remit to: Forest Hills Swim Club P.O. Box 54440 Cincinnati, Ohio 45254