Request for Membership Information

Thank you very much for your interest in Membership at The Club at Prescott Lakes. Please take a few moments to fill out the information below and we will be in contact with you to answer your questions and to schedule a time for you to visit the Club. You may also contact our Club Membership Director, Mishael Wells, directly at 928.443.3527 (toll-free 877.643.3501) or at

Your Name (First & Last) *

Address, City, State, Zip *

Home Phone *

Work Phone *

Cell Phone *

Email Address


If you are a current Member of Prescott Lakes and would like to sponsor someone for membership, please fill out the area above with your nominee's information and make sure to include your information below. Thank you!

Member Name (First & Last)

Member #

Phone Number

Email Address


Please type the alphanumeric sequence in the image above: