Spousal Membership Application

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Candidate Information
Prefix:*
First Name (required):*
Middle Name:
Last Name (required):*
Surname at Harvard, if applicable:
Harvard Affiliations(s)/School(s) (required):*
Graduation Year(s) (required):*
Non Graduate Affiliation:
- Faculty
- Officer
- Board/Committee Member
Non Graduate Affiliation Date(s) of Service:
Harvard ID# (if known):
Other Educational History
Undergraduate University/College (required):*
Graduation Year (required):*
Gender (required):*
- Male
- Female
Date of Birth (required):*
Date Format: MM slash DD slash YYYY

Format: mm/dd/yyyy
Marital Status:
- Single
- Married
- Divorced
- Domestic Partner

Membership Information
Membership Type (required):*
- Resident
- Suburban
- Non-resident
Click here, for more info on membership types
Other Membership Category:
Check all that apply to you:
- Previously Applied for membership.
- Been a member of the Club.
Primary Contact Information
Email:*
Phone:*
Address:*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Business Contact Information
Email:
Phone:
Address:*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Send Official Communication To:*
- Primary
- Business
Interested in learning more about Fitness Membership?
- Yes
Consent*
- By checking this box, I hereby sign and authorize the Welcoming Committee to make any necessary actions and inquiries to process this application. I also agree to abide by the Club's By-Lacws and House Rules if I become a member and to pay when due all Club charges as invoiced to me.
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Candidate Information