Name

Address Street Address

City

State

Zip

Contact Information home phone

work phone

email

Demographics date of birth

age

occupation

National Ski Patrol status new applicant registered NSP patroller

Number of years you have been skiing 0 1-2 years 3-5 years 5-10 years 10+ years

Number of Hours of Skiing Lessons you have received 0 1-2 hours 2-5 hours 5-10 hours 10+ hours

Applying for Auxiliary (non skier patroller) Basic (ski and toboggan patroller)

skier snowboarder Skier Snowboarder

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