Somerset Point & Stilley Membership Program Enrollment

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First Name
Last Name

If you will be retiring on or before end of current year, please select the “Retiree” Option.

Employee Number
Mail Code
Home Address
City, State, Zip Code
Email Address
Phone Number
Work Extension

Eligible Dependents ?

Do you have a spouse?

Payroll Deduction (24 Pay Periods)

 I acknowledge that I have read and agree to the following payroll deduction terms and conditions.

I hereby authorize Santee Cooper to deduct the above amount from my bi-weekly pay for an Annual Recreation membership. I understand this sum cannot be refunded. I represent that this authorization is executed voluntarily and has not been made as a condition of my continued employment.

 I acknowledge that I have read and agree to the membership guidelines.