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GOOD GO ING HUNTING

1188 192nd Street * Baldwin, Wisconsin 54002 * Telephone (715) 796-2392

Membership Application - Applicant Profile

Your name will be submitted for possible consideration for membership. We ask you to provide us information about yourself and your background. Completion of this form does not confer any rights to use the facilities or membership privileges. Please complete this questionnaire. All information will 
be considered personal and confidential.

I.  Membership                     Date of Application:______________
       	Indicate type of membership desired:

           	_____Individual	  _____Family    _____Corporate/Group 

        State reasons for joining:
        __________________________________________________________________
        __________________________________________________________________

II.  Personal information
	Full Name:______________________________ Date of Birth:___________
        Home Address:_____________________________________________________
        City:__________________________ State:_________________ Zip:______
        Phone:__________________________ Marital Status:__________________
        Spouse's Name:____________________________________________________
        Children's Names and Ages:________________________________________
        __________________________________________________________________

III.  Business/Professional
	Applicant's Employer:_____________________________________________ 
	Type of Business__________________________________________________
	Address:__________________________________________________________
	City:________________________ State:_________________ Zip:________
	Phone:__________________ Occupation/Title:________________________

     	Spouse's Employer:________________________________________________
	Type of Business__________________________________________________
     	Address:__________________________________________________________
     	City:______________________ State:__________________ Zip:_________
     	Phone:_____________________ Occupation/Title:_____________________

I hereby authorize the disclosure and release of information to Good Go 
Ing Hunting for purpose of investigating my character and reputation. 
I certify that, to the best of my knowledge, the foregoing information 
is correct.  I understand that any misrepresentation shall be cause for 
denial of further consideration.

If elected to membership, I agree to abide by the by-laws, rules and 
policies as set forth by the membership, management, and the 
owners.

I also agree, if elected to membership, to pay the dues corresponding 
to the hunting plan chosen, and any other charges as and when applicable.

Signature of Applicant:____________________________ Date Signed:__________

Date Approved:___________________ 

Signature of Good Go Ing Representative:__________________________________