This form is to be filled out only if you are choosing to terminate your membership.
Please attach your bond to this form, if a paper bond was issued, and send to the address below no later than March 15, 2021. If not received by this date, a late fee of $50 will be deducted from your bond refund.
Maggie Stephey
Membership Chair
801 McComb Ln
Chadds Ford, PA 19317
I, (write name which appears on Certificate):________________________________________________
of (write full address):____________________________________________________________________
request that our membership in the Green Woods Club, Inc. be terminated.
Signature of Certificate Holder: ______________________________________Date:___________________
Phone: _______________________________________ Email Address: _____________________________
If you are moving and would like the refund check sent to your new address, please complete:
New Mailing Address: ____________________________________________________________________
New Phone:______________________________________
Please Note The Following:
Your refund will be issued to you upon the sale of your bond. You should expect a refund by mid-June. If you are unable to find your bond, please complete the Lost Bond Waiver Form. Contact the membership chair, Maggie Stephey, with any questions.
For Pool Use Only
Cert#________Date Received :________Refund Amt $:________Refund Check No.: ________