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New Member Application
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Location - Select Your Home Lounge
*
Atlanta - Buckhead
Atlanta - Downtown
Dallas / The Colony
Miami / Brickell
Nashville - Music City
Primary Applicant Name
*
First
Last
Please enter your legal name
(
must
match photo identification)
Occupation
Email
*
Phone
*
Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Membership Type
Membership Level - Select One
*
Select Membership Level
Associate Membership - $ 350.00
Premium Cigar Locker Membership - $ 1,000.00
Corporate Membership - $ 3,000.00
Executive Membership - $ 5,000.00
Cigar Locker Name Plate (Up to 18 Characters)
Please Enter Text (Cigar Locker Name Plate)
Please enter the exact text you would like on your locker's name plate.
Additional Members (Corporate)
Name
First
Last
Email
Email
Confirm Email
Phone
Additional Member #2
Name
First
Last
Email
Email
Confirm Email
Phone
Additional Member #3
Name
First
Last
Email
Phone
Additional Member #4
Name
First
Last
Email
Email
Confirm Email
Phone
Applicant Signature
Signature
*
Clear Signature
I understand to guarantee my membership stays continuous with no interruptions or changes of benefits, I understand and agree to adhere to all Red Phone Booth rules and regulations as amended from time to time. Red Phone Booth reserves the right to suspend or cancel membership privileges at any time or for any reason. I certify that the credit card listed is issued to me and agree to always keep a valid and approved credit card on file with Red Phone Booth. All memberships will automatically renew, and my card will be charged on an annual basis. I may cancel my membership at any time without refund with a 30-day written notice.
Please Confirm Today's Date
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