Official PSC Use Only: Memb.#______________Am't
Recv'd__________________Cash_________Ck#______________
Please print everything very clearly: Today's Date: _______________________
Last Name:________________________________ First Name:_____________________________
Home Phone: ( )_____________________ Work: ( )_____________________ Cell: ( )_____________________
Others in Household Who are Joining:__________________________________________________________
Marital Status: Single ___________ Married _____________
Street Address: _____________________________________________________________________________
City: _____________________________________ State: ___________ ZIP: ____________________
E-mail address (for our membership directory):
______________________________________________
Please check all that apply: Renewing Member____ New Member____
Downhill skier____
Cross country skier_____ Snowboarder _____
Non-skier_____ I want to learn to ski______
Birthdate: _______________________ How did you hear about the PSC?____________________________
Were you referred by a member? _______________ If so, who? ___________________________________
Do you usually buy a season ski pass?________ If so, where? _________________________________
If you do NOT want to be listed in our annual membership directory check here __________
Check here _____ if you want to receive your newsletter via e-mail instead of having a printed copy mailed to you.
I can help serve on Hospitality____ Membership____ Program____ Publicity____ Racing____ Travel____
Annual Dues: adults 21+ are $25; additional adults at same
address are $15 each. Children under 21, with adult, are
$10 each. Memberships will be effective from today until May 31, 2008. The PSC's
Constitution requires that
membership newsletter privileges be terminated unless renewal dues are received by
July 31st.
Send all 3 -- your application, check, and a SELF-ADDRESSED STAMPED
ENVELOPE to:
PSC Membership, PMB # 179, 414 South Craig Street, Pittsburgh,
PA 15213-3709
As a member I hereby waive all rights to claims
for injury, loss, or damage arising through any activities of the Pittsburgh Ski Club.
Signature ________________________________________________