2010 Membership Application

Please return membership application with payment to:

Western Lakes Golf Club
c/o Memberships
W287 N1963 Oakton Rd.
Pewaukee, WI 53072

Last Name	_______________________________
First Name(s)	_______________________________	_______________________________
Address	____________________________________________________
City/State/Zip	____________________________________________________
Home Phone	(_______) ________ - _____________
Work Phone(s)	(_______) ________ - _____________	(_______) ________ - _____________
Mobile Phone(s)	(_______) ________ - _____________	(_______) ________ - _____________
Email Address(s)	________________________________	________________________________

Circle Membership and any additional options to purchase

	Price if Paid By...
	2/15/2010	after 2/15/2010
Full Single Membership	$1475 ($75.23)	$1625 ($82.88)
Full Couple	$2175 ($110.93)	$2400 ($122.40)
Thurs/Sat Single	$1050 ($53.55)	$1200 ($61.20)
Thurs/Sat Couple	$1600 ($81.60)	$1800 ($91.80)
***Associate Single Membership	$250 ($12.75)	$350 ($17.85)
***Associate Couple	$450 ($22.95)	$550 ($28.05)

***Associate Membership includes 30% discount on regular summer green fees.
Discount does not apply to spring, fall, or promotional green fees.
***Sales tax(es) in parentheses.

Pay Now
&
Save Big!!!

Up to $300
In Savings!!!

	Price if Paid By...
	2/15/2010	after 2/15/2010
Single Golf Cart Memberships	$575 ($29.33)	$625 ($31.88)
Couple Golf Cart Memberships	$850 ($43.35)	$925 ($47.18)
Locker/Towel	$100 ($5.10)	$100 ($5.10)

5.1% State/County Sales Tax will be added to all prices

Sub Total	$____________
Sales Tax	$____________ (Enter Above Sales Tax)
Grand Total	$____________	Amount Enclosed	$____________
Check Number	_____________
OR
Credit Card #	____________________________________	Card Type	_______________
Name on Card	____________________________________	Expires	_______/_______