Coupon 1 (One event or trip per coupon please)
Name of Event:      Event Date:

Name:      Member Number:

Name:      Member Number:

Name:      Member Number:

Street Address:

City:     State:     Zipcode: -


E-mail Address:

Number of Members @         $  = $

Number of Non-Members @ $  = $ (Where allowed)

No of    @      $  = $ (Children, Guests)

Total Enclosed $

Don't forget a self–addressed, stamped envelope, if you didn’t provide an e–mail address.
Mail coupon and check to the trip Contact person. Make checks payable to “PSC”.

If your check is returned from the bank for insufficient funds, you may be required to pay PSC the NSF/Returned Check fee.


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