7676 Forsyth Boulevard, Suite 130 • Saint Louis, Missouri 63105
Phone: 314‐726‐1964 • Fax: 314‐862‐5528
Web: www.stlclub.com

MEMBERSHIP APPLICATION

Saint Louis Club membership can advance your career and your company ... expand your business and social networks ... allow you to hold high-level conversations and close high-dollar deals ... advance the causes that matter to you ... and ... help you celebrate life's milestones ... all while enjoying the city's finest dining, the world's finest wines, the freshest, most innovative cocktails with our region's most interesting people.

Type of membership (please check one):

APPLICANT INFORMATION

Name (Last, First, Middle):

Birthdate

Street Address:

City:

State:

Zip:

Cell Phone:

Email:

BUSINESS INFORMATION

Name of Business:

Job Title:

Business Address:

City:

State:

Zip:

Business Phone:

Business Email

Secondary work email address? (administrative assistant):

SPOUSE/PARTNER/FAMILY INFORMATION

Name (Last, First, Middle):

Cell Phone:

Birthdate

Name of Business:

Job Title:

Business Phone:

Email:

Wedding Anniversary:

Ages of Children:

APPROVAL INFORMATION

Sponsoring Member Name:

Seconder's Name:

Applicant Signature:

Date:

ALTERNATE ADDRESS (i.e. vacation home, 2nd office, accountant, etc.)

Name (Last, First, Middle):

Alt Phone:

Street Address:

City:

State:

Zip:

BACKGROUND

How long have you been a resident of St. Louis?

Schools attended:

Professional, Civic, Charitable Organizations:

Other private clubs:

Would you prefer to receive statements by USPS, email or both?

If you would like statements by mail, which address would you prefer?

Would you prefer to receive Club news by USPS, email, or both?

If you would like Club news by mail, which address would you prefer?

SPECIAL NEEDS

Please indicate any allergies, dietary restrictions or special needs or requests:

Member:

Spouse:

Please note, completing this application does not guarantee membership in the Saint Louis Club.

We will contact you about the next steps in our application process.

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