Membership Application

Step 1 of 5

Applicant Information

Tell us who you are. Required fields are marked with *.

Full Name * Email * Birthdate Cell Phone Spouse / Partner Name Spouse Birthdate Anniversary Date Home Phone Mailing Address

Step 2 of 5

Employment Information

Optional, but helpful for our membership committee.

Place of Employment Position Employer Address

Step 3 of 5

Membership Category

Choose the membership tier that fits you best. Not sure? Pick the closest match — we'll confirm during review.

Golf Memberships Single Golf Family (1) Golf Family (2) Golf 4-Day Golf Non-Resident Golf Associate 21–29

Social Memberships Single Social Family Social

Pool Pool Membership

Step 4 of 5

Family Members

List dependent family members who will use the club, with birthdates if available.

Family Members

Final Step

Agreement & Signature

Please review and sign below to submit your application.

By signing this application, I certify that the information provided is accurate to the best of my knowledge. I agree to abide by the rules, regulations, and bylaws of Susquehanna Valley Country Club, and I understand that my application is subject to review and approval by the membership committee. I authorize SVCC to contact me regarding this application.

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Sign here using your mouse, finger, or stylus

Type your full legal name as your signature

Printed Name * Date

You'll receive a confirmation email at the address provided.

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