Membership Benefits 2018

Membership Benefits 2018 Brookfield County Club

Brookfield Country ClubDear Friend- Thank you for inquiring about membership opportunities with Brookfield Country Club. As a family oriented private country club, we recognize the importance of spending quality time with your friends and loved ones. Founded in 1927 and located just 20 miles from Buffalo, Brookfield has been a home away from home for hundreds of members for sever- al generations. Our Club is a premier private facility in the Western New York Region and is owned by stockholders, sub- stantially all of whom are members. Brookfield Country Club boasts 18 pristine holes, a 3 hole practice course, driving range, and chipping & putting greens over an expansive 170 acres. Our Club completed an exciting $2 million update to the golf course in 2016, which has made it one of the premier courses in greater Buffalo-Niagara. With treelined fairways, lush landscaping, and perfectly manicured greens, our parkland course is perfect for those looking for a course they can call home. But at Brookfield, it’s not just golf. Four tennis courts, a seasonal outdoor swim complex, superb dining facilities and friendly social events complete the experience for the whole family. Our junior development programs start at age 3 for swim and tennis, and age 5 for golf, fostering a love of these sports which can last a lifetime. It’s not all fun and games however, sometimes it’s just fun! Brookfield hosts more than 30 social events throughout the year from our Annual 4th of July Family Picnic and monthly Ladies’ Nights, to Men’s Raw Bar and BBQ, and festive Holiday traditions. There are plenty of events to share with just your friends, other couples, and even the family. Our 2018 membership types are as follows: All memberships include full use of the Clubhouse & dining, recreational swimming pool, and tennis for you and your immediate family (spouse and dependents up to age 25 who are living at home or enrolled full time in college). The only difference is if you love to golf a lot or just a little! Golf Membership Junior (Age 21-29), Junior Executive (Age 30-39) Executive (Age 40-44), Resident (Age 45+) As a Family golf member of Brookfield Country Club, you are entitled to unlimited use of the golf course and practice facilities for yourself and your immediate family. An Individual golf membership would include full usage as listed above, but spouse would not have golf privileges. Golf memberships are based on age classifi- cation, and you will be automatically moved into the appropriate age category when reaching the respective age. Social Membership Social membership is perfect for individuals or families who are looking for a full Club experience, but with limited golf. This affordable membership grants full Club usage to the entire family, with golf privileges ex- tended once per month with the payment of greens fees, to the primary member. Membership at Brookfield is by invitation and requires sponsorship by two current members. If you do not know any current members, we would be happy to introduce you to our Membership Chair who could arrange sponsorship with appropriate members.We are confident that one of these categories will fulfill your requirements and look forward to answering any questionsyou may have. Than you again for your time and consideration.All the best,Lisa P. HarrisDirector of Membership & Marketing 5120 SHIMERVILLE ROAD, CLARENCE, NY 14031 | 716-632-2500 | BROOKFIELDCC.COM

Brookfield Country Club 2018 Spring Membership OffersUpon enrollment, new members may have full use of club privileges with no obligation of dues or food and beverage minimum until May 1, 2018. Initiation fee to be billed upon enrollment on one year plans. New entrants electing three year plans shall pay initiationfee upon enrollment, or they may elect 2 installments of 50% at enrollment and 50% on first year anniversary, with an additional $500 added to the original initiation fee. One Year Plan Three Year Plan 12 month commitment of paid dues 36 month commitment of paid dues Golf Membership Golf Membership Junior (Age 21-29) Junior (Age 21-29) Initiation Fee: $1,500 Initiation Fee: $750Maximum Operational Assessment for 12 Months: $0 Maximum Operational Assessment for 12 Months: $0 4 Complimentary Greens Fees 4 Complimentary Greens Fees Junior Executive (Age 30-39) Junior Executive (Age 30-39) Initiation Fee: $5,000 Initiation Fee: $2,500Maximum Operational Assessment for 12 Months: $0 Maximum Operational Assessment for 12 Months: $0 4 Complimentary Greens Fees 4 Complimentary Greens Fees Executive (Age 40-44) Executive (Age 40-44) Initiation Fee: $8,000 Initiation Fee: $4,000Maximum Operational Assessment for 12 Months: $0 Maximum Operational Assessment for 12 Months: $0 4 Complimentary Greens Fees 4 Complimentary Greens Fees Resident (Age 45+) Resident (Age 45+) M Initiation Fee: $15,000 Initiation Fee: $7,500 bMaximum Operational Assessment for 12 Months: $500 Maximum Operational Assessment for 12 Months: $500 c 4 Complimentary Greens Fees 4 Complimentary Greens Fees a y Social Membership Social Membership G Initiation Fee: $1,500 Initiation Fee: $0 $Maximum Operational Assessment for 12 Months: $0 3Complimentary Greens Fees Maximum Operational Assessment for 12 Months: $0 a 3Complimentary Greens Fees ti m All prices are subject to 8.75% New York State Sales Tax-At the time of joining, all members are required to purchase: One share of Brookfield Country Club Stock for $500 plus tax Membership Referral IncentivesExisting member who refers a new golf member will receive 4 complimentary greens fees and the equivalent of one(1) month of the new member’s dues, distributed in Club credit over 12 months (not to be used on golf shop merchandise) ~Existing member who refers a new social member will receive 3 complimentary greens fees and the equivalent of one(1) month of the new member’s dues, distributed in Club credit over 12 months (not to be used on golf shop merchandise)5120 SHIMERVILLE ROAD, CLARENCE, NY 14031 | 716-632-2500 | BROOKFIELDCC.COM

Brookfield Country Club 2018 Annual Membership Dues M bAnnual dues cycle runs from January to December. Members may choose to pre-pay the full amount on December 31 of each year, or c elect to be billed in monthly installments. a y Golf Membership G $ Junior (Age 21-29) Individual dues: $265/mo. | Family dues: $315/mo. a ti Monthly Food & Beverage Minimum: $0 m Junior Executive (Age 30-39) Individual dues: $349/mo. | Family dues: $399/mo. Monthly Food & Beverage Minimum: $55 Executive (Age 40-44) Individual dues: $460/mo. | Family dues: $510/mo. Monthly Food & Beverage Minimum: $82.50 Resident (Age 45+) Individual dues: $608/mo. | Family dues: $664/mo. Monthly Food & Beverage Minimum: $110 Social Membership Individual dues: $265/mo. | Family dues: $315/mo. Monthly Food & Beverage Minimum: $110 All prices are subject to 8.75% New York State Sales Tax-At the time of joining, all members are required to purchase: One share of Brookfield Country Club Stock for $500 plus tax Club Plan All golf members are to be billed an annual fee of $415 Individual or $750Family to include: Range, Bag Storage, Locker Rental, GHIN Social members may subscribe to Bag Storage or Locker Rental as space permits, for $130 each5120 SHIMERVILLE ROAD, CLARENCE, NY 14031 | 716-632-2500 | BROOKFIELDCC.COM

Brookfield Country ClubGolf Membership AGE CLASSES Official Golf Season April 1st—October 31st Junior - Age 21-29 Opening and closing dates are determined by weather at the Junior Executive- Age 30-39 Superintendent’s discretion Executive- Age 40-44 Golf Course Opening Hours Resident- Age 45+ Date Monday Weekday Weekend All age classes available as individual or family membership March 1-March 31 1:00 pm 9:00 am 8:00 am 8:00 am 7:00 am PRIVILEGES & BENEFITS April 1– May 8 1:00 pm 7:00 am 6:30 am 8:00 am 7:30 am Golf May 9-Sept. 4 1:00 pm 9:00 am 8:30 am• Unlimited rounds with reduced greens fees for immediate Sept 5– Nov 13 1:00 pm family Nov 14—End of season 1:00 pm• Park-land course in a private setting with no public play• No tee times, unless otherwise specified due to special Guest Rules events From April 30– September 30, members that invite guests to play• Multiple sets of tee boxes designed to challenge golfers of should any skill level adhere to the following:• Full access to driving range, putting & chipping greens, Thursday: Before 12 pm or after 2 pm Friday: Tee time req. for play between 11 am– 3pm and 3-hole practice course Saturdays, Sundays, and Holidays: After 10 am• Ability to walk course or rent electric cart Sunday: Tee time req. for play after 10 am• Complimentary pull carts• Reciprocal club program available Guests are limited to playing one time each month. An• Men’s, Ladies, Couples and Junior events individual cannot be the guest of more than one member in• Established Junior Development program in golf, tennis any one month, with the exception of play in special events. and swim for your children and grandchildren ADDITIONAL BENEFITS OF MEMBERSHIP• Active schedule of Club tournaments such as: Tennis •Club Championship •Directors’ Cup •Two-Day Invitational 4-court tennis facility with access to lessons, clinics, interclub events,•Summer Invitational •Mr.& Mrs. Championship •President’s Cup tournaments and junior tennis •Senior Championship •Brookfield/Crag Burn Classic• Private and group lessons with the Head Professional or Pool Heated outdoor recreational pool with lanes for adult laps and junior Assistant Professional swim meets. Lessons and clinics available. Complete changing areas• Fully stocked on site Golf Shop complete with the latest and showers, lounge chairs, covered dining area, and snack bar. lines in golf equipment and apparel for men, women, and Guests privileges available at a small fee. children Dining Golf Services À la carte dining available in the Grill Room, Men’s Card Room, and• Fully appointed Outside Patio men’s and ladies’ locker rooms Club Events with showers, Monthly men's, ladies, couples & family events such as Men’s Raw towels, personal amenities, shoe Bar, Ladies’ Social Night, Barn Bash, service and small shared work out facility Clam Bake, Family Halloween Party, Turkey Trot Golf, President’s• Locker rental and bag storage Ball and so much more! Private Events Host or sponsor an event in the Ballroom, Meadowbrook Room, or Terrace5120 SHIMERVILLE ROAD, CLARENCE, NY 14031 | 716-632-2500 | BROOKFIELDCC.COM

Social Membership AGE CLASSES ADDITIONAL BENEFITS OF MEMBERSHIP Available to all members over the age of 21. All Social Tennismemberships include full Club usage (except golf) for the immediate 4-court tennis facility with access to lessons, clinics, interclub events, family (spouse and children who live at home under the age of 25). tournaments and junior tennis Limited golf privileges are available to the primary member Pool PRIVILEGES & BENEFITS Heated outdoor recreational pool with lanes for adult laps and junior swim meets. Lessons and clinics available. Complete changing areas Golf and showers, lounge chairs, covered dining area, and snack bar.• One(1) 18-hole round of golf per month with payment Guests privileges available at a small fee. of greens fees, and access to tournaments when not fully subscribed (primary member only) Dining À la carte dining available in the Grill Room, Men’s Card Room, and• Park-land course in a private setting with no public play• No tee times, unless otherwise specified due to special Outside Patio events Club Events• Multiple sets of tee boxes designed to challenge golfers of Monthly men's, ladies, couples & family events such as Men’s Raw any skill level Bar, Ladies Social Night, Barn Bash,• Access to driving range, putting & chipping greens, and 3- Clam Bake, Family Halloween Party, Turkey Trot Golf, President’s hole practice course on day of 18-hole round Ball and so much more!• Ability to walk course or rent electric cart• Complimentary pull carts Private Events• Reciprocal club program available Host or sponsor an event in the Ballroom, Meadowbrook Room, or• Men’s, Ladies, Couples and Junior events• Ability for children to participate in established Junior Terrace Golf program Golf Course Opening Hours• Private and group lessons with the Head Professional or Date Monday Weekday Weekend Assistant Professional 9:00 am 8:00 am• Fully stocked on site Golf Shop complete with the latest March 1-March 31 1:00 pm 8:00 am 7:00 am 7:00 am 6:30 am lines in golf equipment and apparel for men, women, and April 1– May 8 1:00 pm 8:00 am 7:30 am children 9:00 am 8:30 am May 9-Sept. 4 1:00 pm• Fully appointed men’s and ladies’ locker rooms with show- ers, towels, personal amenities, shoe service and small Sept 5– Nov 13 1:00 pm shared work out facility Nov 14—End of season 1:00 pm• Locker rental and bag storage as space permits Guest Rules Optional Annual Golf Services From April 30– September 30, members that invite guests to play Bag Storage $130 per bag should adhere to the following: Locker Rental $130 each, as available Thursday: Before 12 pm or after 2 pm Friday: Tee time req. for play between 11 am– 3pm Range $130 Saturdays, Sundays, and Holidays: After 10 am Official Golf Season Sunday: Tee time req. for play after 10 am April 1st—October 31st Opening and closing dates are determined by weather at the Guests are limited to playing one time each month. An individual cannot be the guest of more than one member in any one month, Superintendent’s discretion with the exception of play in special events.5120 SHIMERVILLE ROAD, CLARENCE, NY 14031 | 716-632-2500 | BROOKFIELDCC.COM

Golf Programming Sample summer scheduleSunday Monday Tuesday Wednesday Thursday Friday Saturday Clubhouse Ladies 9-Hole Ladies 18- Ladies Social Jr. Interclub Closed League (AM) Hole League Golf (PM) Couples Golf Men’s League Junior Play (AM) (PM) (AM) (PM) Jr. ClinicsCourse openSample of Club Tournaments Men’s Golf: Stag Days – Thursdays (once per month) Club Championship Kozlin Heritage Tournament Men’s League –Tuesday (PM) Summer Invitational Ladies’ Golf: Two-Day Invitational Ladies 9-Hole League – Tuesdays (AM) Member / Member I Ladies 18-Hole League – Wednesdays (AM) Member / Member IIMr. & Mrs. Club Championship Ladies Social Golf – Thursdays (PM) Interclub 9/18 President’s Cup Senior Championship Couples /Social Golf: Brookfield/ Crag Burn Classic Couples Golf (Friday Nights) 9 & Dine (once per month) Harvest Cup Parent-Child Tournament Youth Golf:Junior Golf 3/6/9/13/18 Hole – Mondays (AM) All level clinic – Wednesdays Interclub – FridaysReciprocal Club ArrangementArrangements have been made with the following our of town clubs to permit Brookfieldmember the opportunity to enjoy golfing privileges without the payment of guest fees.Bellevue Country Club Cobblestone Creek Country Club Moonbrook Country ClubSyracuse, NY Victor, NY Jamestown, NYBrook-lea Country Club Irondequoit Country Club Plantation Golf & Country ClubRochester, NY Rochester, NY Venice, FLBurlington Golf & Country Club Kahkwa Club Stafford Country ClubHamilton, Ontario CA Erie, PA Stafford, NYCherry Hill Country Club Locust Hill Country Club Teugega Country ClubOntario CA Pittsford, NY Rome, NY Wanakah Country Club Hamburg, NY5120 SHIMERVILLE ROAD, CLARENCE, NY 14031 | 716-632-2500 | BROOKFIELDCC.COM

Junior Sports GuideOur staff is dedicated to making all junior sports programs fun, educational, and safe for your children. Statisticsshow that children who are introduced to golf at an early age are likely to play golf for life! We hope that you will give your child the opportunity to make golf , tennis, or swimming a part of their life and receive the many benefits that the sports can provide. Children and grandchildren of members of ANY classification are eligible for the Junior Golf Program, and most of our sessions group participants by skill. Golf Monday tournament play starts at age 8 and Wednesday clinics start at age 5. Junior golfers ae placed at the appropriate hole lev- el based on a combination of age, performance, and knowledge of rules and etiquette. Tennis Tuesday and Thursday Clinics are a series of large group lessons. Starts at age 3.Junior Interclub Tennis is a competitive match play program designed to allow children the opportunity to play tennis against other children from, area country clubs. Groups start at 10 and under. Swim Tuesday and Thursday 30 minute Clinics are a series of small group sessions that group children by skill. Starts at age 3. Brookfield Barracuda Swimming and Diving Team competes against juniors from other area country clubs and groups starts at under 6. Dining Hours of ServiceGRILL ROOM & MEN’S CARD ROOM HALFWAY HOUSEAPRIL THROUGH DECEMBER IN SEASON TIPPINGMonday Closed Monday Closed A 15% tipping charge is added automati- cally to all Food & Beverage Checks. TheTues– Sat 11:30 am - 10:00 pm Tues– Fri 8:30 am - 7:00 pm weekly amount of tips is prorated andSunday 10:30 am - 10:00 pm Sat– Sun 8:00 am - 7:00 pm equally shared by every member of the service staff. Any amount added to theJANUARY THROUGH MARCH POOL SNACK BAR check above 15% or any cash tips given remain with the server for whom it wasMon-Tues Closed IN SEASON (JUNE 24– SEPT 4) intended.Wed & Thurs 11:30 am - 9:00 pm Mon– Fri 8:30 am - 7:00 pmFri & Sat 11:30 am - 10:00 pm Sat– Sun 10:30 am - 7:00 pmSunday 10:30 am - 10:00 pm OFF SEASON (MAY 29 - JUNE 23) Sat– Sun 11:00 am - 7:00 pm 5120 SHIMERVILLE ROAD, CLARENCE, NY 14031 | 716-632-2500 | BROOKFIELDCC.COM

Referral benefit Were you referred for membership by a current Brookfield member? If so, we would love to show our appreciation to him or her by awarding a referral benefit. Please list the name of the Brookfield member who referred you: ________________________________________________________________If you join in 2018 as a new Golf member, this member will receive 4 complimentary greens feesand a statement credit equivalent to one month of your dues. If you join as a new Social member, this member will receive 3 complimentary greens fees and a statement credit equivalent to one month of your dues. Please be sure to redeem this form with your application.Did 2 or more members refer you? Please note that any additional members listed would split the above referral benefit. Pay It ForwardAfter acceptance of membership, you will be eligible to earn referral benefits as well by referring your friends, family, and colleagues for membership! There is no limit to the amount of benefits you can earn by referring new candidates for membership. 5120 SHIMERVILLE ROAD, CLARENCE, NY 14031 | 716-632-2500 | BROOKFIELDCC.COM

Brookfield Country Club, Inc. MEMBERSHIP5120 Shimerville Road APPLICATIONClarence, NY 14031 CANDIDATE INFORMATIONCANDIDATE’S NAME____________________________ _________ _____________________ Hon. Dr. Mr. Mrs. Ms. Miss (First) (M.I.) (Last) (Salutation, please circle)DATE OF BIRTH: ____/ ____/____ S.S. # ___________________ FAMILIAR NAME _________________________ (or Nickname)PRIMARY E-MAIL ADDRESS: __________________________________PRIMARY PHONE __________  Check if cellADDRESS: ______________________________________ CITY/STATE __________________________ Zip _________ CLUB MEMBERSHIPMEMBERSHIP DESIRED:  Resident Golf  Executive Golf  Jr. Executive Golf  Junior Golf Social (Age 45+) (Age 40-44) (Age 30-39) (Age 21-29) (Age 21+) GOLF MEMBERSHIPS TYPE:  Individual  Family (includes golf privileges for children under the age of 25) ((includes golf privileges for spouse & children under the age of 25) Please check if you are related to a current or former member Name/ Relation: _____________________________CURRENT OR FORMER MEMBERSHIPS: START: END: GOLF/COUNTRY CLUBS: __________________________________ ________________ _________________ _______________________________________________________ ________________ _________________ CITY/OTHER:____________________________________________ ________________ _________________ _______________________________________________________ ________________ _________________PLEASE LIST TWO MEMBERS WHO ARE WILLING TO SPONSOR YOU FOR MEMBERSHIP: (LEAVE BLANK IF UNKNOWN AT THIS TIME)1.)_________________________________________2. _____________________________________________ FAMILYSPOUSE’S NAME____________________________ _____________________ _________ Hon. Dr. Mr. Mrs. Ms. Miss (Last) (First) (M. I.) (Salutation, please circle)DATE OF BIRTH: ____/ ____/____ ANNIVERSARY: ____/ ____/____ FAMILIAR NAME ____________________ dd/ mm / yyyy dd/ mm / yyyy (or Nickname)PRIMARY E-MAIL ADDRESS: __________________________________PRIMARY PHONE __________DEPENDENT CHILDREN UNDER AGE OF 25 YRS.  Check if cellFIRST MI LAST NICKNAME DATE OF BIRTH: SEX: M OR________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________FOOD ALLERGIES/ DIETARY RESTRICTIONS:TYPE NAME____________________________________________________________________________________________________________________________________________________________________________________________ Continued on reverse

Brookfield Country Club, Inc. ADDITIONAL5120 Shimerville Road ROSTER INFORMATIONClarence, NY 14031 BUSINESS & ADDITIONAL CONTACT INFORMATION CANDIDATE SPOUSEOCCUPATION: _________________________________ OCCUPATION: _________________________________TITLE/ POSITION: ______________________________ TITLE/ POSITION: ______________________________EMPLOYER/FIRM: ______________________________ EMPLOYER/FIRM: ______________________________YEARS WITH FIRM: __________________________________ YEARS WITH FIRM: __________________________________ ~ ~ALTERNATE EMAIL: ________________________________ ALTERNATE EMAIL: ________________________________ALTERNATE PHONE: ________________________________ ALTERNATE PHONE: ________________________________  Check if cell  Check if cellALTERNATE ADDDRESS:  Business  Other  Snowbird ALTERNATE ADDDRESS:  Business  Other  SnowbirdSTREET: ______________________________________ STREET: ______________________________________CITY/STATE ______________________Zip _________ CITY/STATE ______________________Zip _________BILLING & CORRESPONDANCE INTERESTSCOMMUNICATION & STATEMENTS: Please check all interests that apply. Special notifications will be sent to primary email address on file.Statements and Board correspondence will be sent to yourprimary address unless otherwise indicated below. Weekly Member Spouse Interest GroupB-Bulletin, monthly Club newsletter and other GolfE-correspondence will be sent to your primary email Tennisaddress unless otherwise indicated. Couples Events Ladies’ EventsSTATEMENTS:  Business  Other  Snowbird Men’s Events Dining & Social EventsE-CORRESPONDENCE:  Alternate email Family/ Kid Friendly Events BowlingROSTER:  Check if you DO NOT want your phone number Junior Sports listed in the roster. Fitness Events Pool EventsCOMMITMENT & INITIATION FEE:  In Full  2 Installments + $500 Cards/Games  In Full  2 Installments + $500  36 Month Commitment  12 month CommitmentANNUAL DUES:  Billed Annually in December  Billed MonthlyBy signing this application, I authorize Brookfield Country Club toverify my personal credit.Applicant's Signature: ________________________________Date: ________________Spouse's Signature: ____________________________________Date: __________________Completion of this form does not guarantee membership. Acceptance is based upon approval by the Board of Directors

Brookfield Country Club, Inc. SPONSOR FORM5120 Shimerville RoadClarence, NY 14031 To be completed by sponsor and returned to Lisa Harris, [email protected] CANDIDATE INFORMATIONCANDIDATE’S NAME____________________________ _________ _____________________ Hon. Dr. Mr. Mrs. Ms. Miss (Salutation, please circle) (First) (M.I.) (Last)AGE: _________________ FAMILIAR NAME _________________________ (or Nickname)PRIMARY E-MAIL ADDRESS: __________________________________PRIMARY PHONE __________  Check if cellADDRESS: ______________________________________ CITY/STATE __________________________ Zip _________MARTIAL STATUS:  Married  Significant Other  Single  Divorced  WidowedSPOUSE’S NAME: _________________________________________________ AGE: __________________________NAMES AND AGES OF DEPENDENTS UNDER AGE 25: ____________________________________________________________________________________________________________________________________________________CANDIDATE SPOUSEOCCUPATION: _________________________________ OCCUPATION: _________________________________TITLE/ POSITION: ______________________________ TITLE/ POSITION: ______________________________EMPLOYER/FIRM: ___________________YEARS_______ EMPLOYER/FIRM: ___________________YEARS________EDUCCATIONAL BACKGROUND: _________________________ EDUCCATIONAL BACKGROUND: ____________________________________________________________________________ ___________________________________________________HOW LONG HAVE YOU KNOWN THE APPLICANT AND WHAT SOCIAL OR BUSINESS CONTACTS HAVE YOU WITH THEAPPLICANT? ____________________________________________________________________________________________________________________________________________________________________________________WHAT CIVIC, COMMUNITY, OR SOCIAL ACTIVITIES IS THE APPLICANT ASSOCIATED?______________________________________________________________________________________________________________________________________________________________________________________________NAME OF CLUBS OF WHICH THE APPLICANT IS A MEMBER: ________________________________________________________________________________________________________________________________________________CANDIDATE IS KNOWN TO THE FOLLOWING BROOKFIELD MEMBERS: ________________________________________________________________________________________________________________________________________WHY WOULD YOUR CANDIDATE MAKE A GOOD MEMBER? ________________________________________________________________________________________________________________________________________________Declaration: I have considered carefully all of the qualifications of the applicant and his/her immediate family. Irecommend them to the Membership Committee without reservation.Print Name: ____________________________ Signature: _____________________________ Date: ____________