NYPD SKI CLUB

PO Box 703
Sleepy Hollow, NY 10591

APPLICATION 2007/2008
RENEWAL : NEW MEMBER:

Last Name: _____________________________   First: ______________________   MI:________
Address: _______________________________________________
City/Town: ________________________________    State: ______    Zip: _____________
Shield: ________________________    Tax: __________________
Home#: _______________________    Cell/Beeper#: ______________________
Rank: ___________________    D.O.B: __________________
E-mail: ___________________________________________________________
Command: ________________________________   Work Phone: ____________________
Work Hours: _______________________________________________________
I would like to be a delegate for Precinct, District or Unit. Yes: No:
Ski Ability:     Never Skied Beginner: Novice: Intermediate: Advanced: Expert:
Snowboarder: Cross Country:
Are you interested in racing Yes: No:

TYPES OF MEMBERSHIP AND DUES:
Active M.O.S $20.00
Retired M.O.S $15.00
Active/Retired M.O.S. 2nd person in same household $15.00
Civilian M.O.S. $15.00
Civilian M.O.S 2nd person in same household $15.00
Honorary Members Friends of the Association $20.00


Sponsor for Honorary Applicant:
Members Name: _________________________________________     Recommnended: Yes:No: Signature:____________________________________ Date: ____________________________
Please make all checks payable to NYPD Ski Club.
Mail to PO Box 703 Sleepy Hollow, NY 10591

Signature: _________________________________________ Date: ___________________________