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2023 - 2024 MEMBERSHIP INTAKE FORM

Thank you for your interest in the Century Club of San Diego.

Each year, we welcome a limited number of San Diegans (typically between 3 to 8 people) to the Century Club. If you are interested in being considered for membership for 2024, please:

1) Review the Member expectations below and acknowledge that you understand them;

2) If you are able to fulfill the expectations, complete the intake form, which captures preliminary information to assist us in learning more about you and your enthusiasm on becoming a Century Club Member.

Please complete each field to the best of your ability. A blank answer may result in the termination of your application. To save your progress, check the box in the upper right corner. To access a previously saved form, click on the link in the upper right.

After completing this form, we will be in touch to discuss the information you provided to understand whether Membership is mutually beneficial to you and the Club.

MEMBER EXPECTATIONS

Please read the expectations listed below and if applicable, acknowledge that you understand them and are able to meet or exceed them.

1) Serve as an ambassador for the Farmers Insurance Open golf tournament, and the Century Club of San Diego organization, including:

Helping tell our story within the San Diego Community
Opening doors within your personal and professional network for our various fundraising and partnership efforts
Spreading the word about how others can help make a difference in all that we do

2) Attend 4-6 general membership meetings and social outings with other members

3) Participate in volunteer activities with our community partner organizations

4) Provide hands-on assistance during Tournament week (typically the last week of January), and other ancillary events

5) Pay the annual dues (typically ranges from $1400 - $2000). Payment would be requested in May of 2024.

I have read the Member Expectations and am more than able to meet them.

YesNo

MEMBER INTAKE FORM - Page 2

Last Name:

First Name:

Personal Information

Preferred Email:

Mobile:

Years in San Diego:

Professional Information

Company:

Company website:

Title:

Description of responsibilities:

Years in role or at company:

Please either upload a recent version of your resume or enter your LinkedIn profile below.

LinkedIn profile:

Community and Social Engagement:

What social, civic, and/or professional organizations do you either currently belong to or have in the recent past?

Describe the charitable organizations or activities you are either currently or have previously supported, whether it be by volunteering, donating, or fundraising? Please include why you chose to be involved.

How did you hear about the Century Club? Please select all that apply.

Social MediaAt or because of the Farmers Insurance Opencurrent or past Century Club Member

Century Club Member(s) name(s):

Why do you want to become a Member of the Century Club?

Thank you for your interest in the Century Club of San Diego.

We encourage you to apply again if your circumstances change and you are able to meet the membership expectations.

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