SAN DIEGO SKI CLUB
MEMBERSHIP APPLICATION
July 1 through June 30*
Last Name_________________________ Date
of Application _______________
Adults: First Name Date of Birth Occupation
______________ ______________
____________________________
______________ ______________
____________________________
Children (under 23 years)
______________ ______________
______________ ______________
______________ ______________
Address:
Street____________________________________________________________________
City________________________________State______ZIP_____________+_________
Home Phone # (_____) _________________
Cell Phone # (_____) __________________
E-Mail:________________________________________________________
(Print Carefully)
CIRCLE --- Category and amount enclosed:
Associate
Family Single (Newsletter Only)
Membership Fees: $65 $55 $20
Circle which committee you would like to
work on:
1. Newsletter 5. Programs 8. Membership
11. Council Rep
2. Adult Racing 6. Activities 9.
Nominating 12. Other________________
3. Junior Racing 7. Travel 10. Meeting
Host at Your House (which month?)
4. Chalet
Make your check payable to "San Diego
Ski Club", and send to:
Amelia Putnam Phone: (858) 882-7273
4141 Alabama St. # 3 E-Mail:
ameliaputnam@gmail.com
San Diego, CA 92104
LIABILITY WAIVER Form MUST BE SIGNED and
included with renewal or new member
application
Date Received _________ Amount Received
___________
________________________________
A(NC-57A):\Membership Form (6-08)
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