2019 New Member Application
This is for new members just joining. If you are looking for returning member dues, see the make a payment tab.
Instructions: Please complete in full the following application. Make payment/s to Nassau Swim Club either by mailing a check to P.O. Box 6, Yorktown, IN, 47396 or click the link here to pay via PayPal (*Additional Fees will apply). If you have any questions please contact us via e-mail at
In which way would you like to join?
Full stock owning, voting privileges membership (total $875)
Non-voting membership (total $500)
Applicant First Name
Applicant Last Name
Spouse First and Last Name (if applicable)
Names and birth dates of children living with you
Baby sitter name ($25 for a summer baby sitter pass)
I will be mailing a check to Nassau Swim Club at PO Box 6, Yorktown, IN 47396
I will be paying right now via PayPal on the link provided on the website
A copy of your responses will be emailed to the address you provided.
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