BEFORE PROCEEDING

• I hereby seek admission to the platinum membership of Le Malt Imperiale. If my application is accepted, I willingly commit to abiding by the established club regulations.
• A recent, clear headshot is a mandatory inclusion.
• In addition to the headshot, please ensure all sections of this form are completed accurately and thoroughly, including other participant details if applying for Joint or Corporate tier.
• Each submission undergoes careful evaluation by our esteemed committee. Any omission of information will render the application incomplete and ineligible for review.
• Rest assured, all provided information shall be treated with the utmost confidentiality.

Note: Proceed with this Corporate application only if the annual dues and initiation fee are to be divided among four participants. Up to four separate 'Corporate (Split Pay)' applications will be required to be completed for each participant. If a single participant is responsible for the payment, kindly return to the previous page and select 'Corporate (Group Pay)' to complete a single application.