PENGUIN SKI CLUB MEMBERSHIP FORM

NAME______________________________________________________________

ADDRESS____________________________________________________________

_________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

TELEPHONE NUMBER_________________________________________

EMAIL ADDRESS___________________________________________________________

TYPE OF MEMBERSHIP INDIVIDUAL____________ FAMILY_______________

IF FAMILY MEMBERSHIP, HOW MANY MEMBERS_____________

AMOUNT PAID___________________ CASH__________ CHECK___________

TRIP SUGGESTIONS (FEEL FREE TO SUGGEST MORE THAN ONE)

1. WHERE______________________________________________________

    WHAT MONTH ____________________________________________

    FULL WEEK, MIDWEEK, LONG WEEKEND________________________

    SELF DRIVE, BUS, PLANE_______________________________________

2.  WHERE______________________________________________________

     WHAT MONTH _______________________________________________

     HOW MANY DAYS____________________________________________

     FULL WEEK, MIDWEEK, LONG WEEKEND________________________

     SELF DRIVE, BUS, PLANE_______________________________________

3.  WHERE______________________________________________________

     WHAT MONTH _______________________________________________

     HOW MANY DAYS____________________________________________

     FULL WEEK, MIDWEEK, LONG WEEKEND________________________

     SELF DRIVE, BUS, PLANE_______________________________________

NON-SKI EVENTS OR ACTIVITIES SUGGESTIONS

1.___________________________________________________________________________

2.___________________________________________________________________________

3.___________________________________________________________________________

PROGRAM SUGGESTIONS

1.____________________________________________________________________________

2.____________________________________________________________________________

3.____________________________________________________________________________

WOULD YOU BE INTERESTED IN SERVING AS A SKI CLUB OFFICER, BOARD MEMBER, ON THE BOARD, OR ON A COMMITTEE?____________________________________________

Revised 2/27/04