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Membership Application

Mr./Mrs./Ms./Miss./Dr./Hon.

First Name

Last Name

Phone

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Street Address

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Employer

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Please Check MEMBERSHIP OPTION:

Platinum Circle (two people) membership - $12,000

Individual age 40 and under - $2,500

Individual membership - $5,000

Name of Sponsor

Prospective members must be sponsored by current members or by the Membership Chair. If you do not know a member, please email membership@lincolnclub.org

I am interested in joining the Lincoln Club because (check any that apply)

I want to meet other businesspeople who share common values/Enjoy networking around politics

I am interested in becoming more informed about public policy issues and their impact on business

A friend recommended that I join

I am a former member and would like to re-join

I am ready to engage and affect political outcomes

Member Two

First Name (Member Two)

Last Name (Member Two)

Email Member Two

Phone (Member Two)

Employer (Member Two)

Job Title (Member Two)

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