INDIVIDUAL MEMBERSHIP REGISTRATION INDIVIDUAL MEMBERSHIP REGISTRATION SECTION 1 - PRIMARY MEMBER INFORMATIONApplicant Name(Required) First Last Preferred Salutation(Required)Mr.Mrs.Ms.Dr.Let Me TypeLet Me Type Date of Birth* (dd/mmm/yyyy)(Required) DD slash MM slash YYYY Gender(Required)MaleFemaleNon-BinaryLet Me TypeLet Me Type Preferred Pronouns (ex: she/her)(Required)He/HimShe/HerThey/ThemLet Me TypeLet Me Type PERSONAL INFORMATIONAddress(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Personal Email(Required) Phone(Required)Phone Type(Required)MobileWorkHomeWORK INFORMATIONTitle/Position Business Name Business Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Business Email Business PhonePhone TypeMobileWorkHomeSECTION 2 - MEMBERSHIP CATEGORY To determine the membership category for which you best qualify and the associated entrance fee, please see Appendix. Please note, the Member (Senior) and Member (Non-Resident) categories are not available to new members. Select the appropriate member category for which you are applying:Membership category(Required) MEMBER MEMBER (Under 40) - must provide copy of ID supporting date of birth ASSOCIATE (Diplomatic) SECTION 3 - NOMINATION SUPPORT A proposer and seconder are required for an application to be considered complete. If you are unable to secure one or both of these endorsements at the time of submission, you may leave this section blank and the Rideau Club will endeavour to secure nominators on your behalf. Please note that this may delay your application process.Proposer Name Seconder Name SECTION 4 - Request for a Business Account (optional) By default, the primary membership is a personal membership. If you wish to establish a secondary account for business-related charges, please provide the appropriate business and contact information below. By checking either box below you are requesting that a sub-account be established and are accepting responsibility for all charges incurred by you on this account.Untitled Same Account Profile Information as provided in Section 1 Different (complete below) Title/Position Business Name Business Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Business Email Business PhonePhone TypeMobileHomeWorkSECTION 5 - Partner/Spouse Information (optional) Partners/Spouses are entitled to use and access the Rideau Club as per the By-Laws and House Rules. Please provide the following information about your partner/spouse, if applicable. A specimen of their signature will be collected upon approval.Consent spouse By checking this box, you are requesting at that sub-account be established for your partner/spouse and are accepting responsibility for all charges incurred by this individual on this account.Partner/Spouse Name First Last Occupation Date of Birth (dd/mmm/yyyy) DD slash MM slash YYYY Preferred Pronouns (ex: she/her)She/HerHe/HimThey/ThemLet Me TypeLet Me Type Preferred SalutationMr.Mrs.Ms.Dr.Let Me TypeLet Me Type Email PhonePhone TypeHomeWorkMobileOtherSECTION 6 - Authorization for Related Party (optional)Consent I authorize the following person(s) to receive copies of account statements and business notices by email.Consent I authorize the following person(s) to make inquiries, provide payments, or request administrative changes to my account for the purposes of maintaining my account in good standing.Authorize Partner/Spouse (as provided above) Other (complete below) Name(Required) First Last Title (if applicable)(Required) Relationship to Member(Required) Email(Required) Phone(Required)Phone Type(Required)HomeWorkMobileOtherSECTION 7 - Communications MEMBER ROSTER As a member of the Rideau Club, your name will appear on the membership roster located in the restricted Member’s Section of the Rideau Club website. You will be able to manage the information displayed and accessible to your fellow members once you receive your login credentials, which will be sent by email. What email address would you like to use for access to the online portal: Personal Business CONTACT PREFERENCES Please indicate where the communications outlined below should be directed by checking the appropriate boxes*. You must select the method of communication for each of the 3 types of information.Account Invoices & Statements(Required) Send via Email Email Address(Required) Home Address Business Address Partner/Spouse Related Party Address(Required) Home Address Business Address Business & Meeting Notices(Required) Send via Email Email Address(Required) Home Address Business Address Partner/Spouse Related Party Address(Required) Home Address Business Address Events & Announcements(Required) Send via Email Email Address(Required) Home Address Business Address Partner/Spouse Related Party Address(Required) Home Address Business Address By selecting email, you are agreeing to receive electronic communications from The Rideau Club.SECTION 8 - Fees, Dues, Special Assessments, Minimums and Methods of Payments For details on entrance, transfer or reinstatement fees, annual membership dues, minimum house account charges and special assessments, as well as payment options and schedules, Click Here As a member, you are responsible to pay all fees, dues and levies associated with membership, as well as any charges incurred at the Club, in a timely manner to keep and enjoy reciprocal benefits and retain a member in good standing status.Acknowledgement(Required) I agree to aboveSECTION 9 - Acknowledgement and Authorization I understand and agree that the Rideau Club will retain certain necessary member information required for the proper conduct of its affairs and that I may review it at any time. I agree to inform the Rideau Club, in a timely manner, of any changes to my membership status, address, email, communication preference, or preferences regarding the distribution of information to other club members. I consent to the broadcast of my name, profession, employer, and likeness to the current membership under the guidelines of Section 20.01 (ii) of the By-Laws. If the Rideau Club accepts my application for membership, I hereby agree to pay all applicable fees and accounts, as they become due, and to accept, abide and be governed by the By-Laws and Regulations passed by the Club and its shareholders.Signature(Required)HiddenDate MM slash DD slash YYYY Appendix Download the By-law hereConsent(Required) I have downloaded and agreed to abide by the By-laws(Required)