La Societe D'elite Membership Application
Please help us better know how to assist you
Name
Gender
Male
Female
Nationality
Partner's Name If Applicable
Gender
Male
Female
Nationality
Address
Afghanistan
Albania
Algeria
Andorra
Angola
Anguilla
Antigua & Deps
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia Herzegovina
Botswana
Brazil
British Virgin Islands
Brunei
Bulgaria
Burkina
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Rep
Chad
Chile
China
Colombia
Comoros
Congo
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faroe Islands
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea North
Korea South
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Saint Vincent & the Grenadines
Samoa
San Marino
Sao Tome & Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Sudan
Spain
Sri Lanka
St Kitts & Nevis
St Lucia
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Other
D.O.B
Phone
Email
Primary Occupation?
SSN
Net Worth
What Are Your Hobbies?
Please Answer Dropdown
How Often Do You Fly Commercial
(A) Always
(B) Very Often
(C) Often
(D) Moderately
(E) Not Often
(F) Want More
(G) Never
How Often Do You Fly Private
(A) Always
(B) Very Often
(C) Often
(D) Moderately
(E) Not Often
(F) Want More
(G) Never
Do You Own A Plane For Air Travel
Yes
No
How Often Do You Travel
(A) Always
(B) Very Often
(C) Often
(D) Moderately
(E) Not Often
(F) Want More
(G) Never
Do You Travel Internationally
Yes
No
If Yes, How Often Internationally
(A) Always
(B) Very Often
(C) Often
(D) Moderately
(E) Not Often
(F) Want More
(G) Never
How Often Do You Take A Cruise
(A) Always
(B) Very Often
(C) Often
(D) Moderately
(E) Not Often
(F) Want More
(G) Never
How Often Do You Charter A Yacht
(A) Always
(B) Very Often
(C) Often
(D) Moderately
(E) Not Often
(F) Want More
(G) Never
Do You Own A Yacht
Yes
No
How Often Do You Travel By Black Car
(A) Always
(B) Very Often
(C) Often
(D) Moderately
(E) Not Often
(F) Want More
(G) Never
How Often Do You Travel Black Car For Business
(A) Always
(B) Very Often
(C) Often
(D) Moderately
(E) Not Often
(F) Want More
(G) Never
How Often Do You Travel Black Car For Pleasure
(A) Always
(B) Very Often
(C) Often
(D) Moderately
(E) Not Often
(F) Want More
(G) Never
Do You Stay At 5-Star Hotels Resorts & Spa
(A) Always
(B) Very Often
(C) Often
(D) Moderately
(E) Not Often
(F) Want More
(G) Never
How Often Do You Attend Sporting Events
(A) Always
(B) Very Often
(C) Often
(D) Moderately
(E) Not Often
(F) Want More
(G) Never
How Often Do You Attend Concerts
(A) Always
(B) Very Often
(C) Often
(D) Moderately
(E) Not Often
(F) Want More
(G) Never
How often Do You Attend Plays
(A) Always
(B) Very Often
(C) Often
(D) Moderately
(E) Not Often
(F) Want More
(G) Never
How often Do You Attend Shows
(A) Always
(B) Very Often
(C) Often
(D) Moderately
(E) Not Often
(F) Want More
(G) Never
How often Do You Desire Fine Dining Reservations
(A) Always
(B) Very Often
(C) Often
(D) Moderately
(E) Not Often
(F) Want More
(G) Never
Desired Membership Interest
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terms of service
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