Name: ________________________________ Spouse: __________________________


Address: _______________________________City:_____________________________


State:_______Zip:_______________Email address:______________________________


Phone:______________________Base:__________________Position:______________


Employee number:_________________


Ski Weeks I would like to attend:____________________________________________


I would like to be a trip coordinator: Yes:_____ No:______


I would like to be a base representative: Yes:_____ No:______

Dues are $10.00 for employee or $15.00 for employee and spouse.

Please remit dues to:

 Continental Ski Club
25560 Wilde Ave
Stevenson Ranch CA 91381
 
Please sign and return enclosed waiver. Your Application is not complete without it.
Thank You