Prospect Form
Date: Point of Interest:
First Name: Last Name:
Email: Contact Phone:
Street/PO:
City:
St: Zip:
Rate your Ability:
Alpine skier Snowboard
Free Heel/ Tele Years Skiing/
Boarding:
First Aid/Medical Training (Check all that apply):
Basic First Aid Adv First Aid CPR
AED EMTB EMT-Advanced
MD Medical Associate First Responder
Other Medical Experience:
Previous Ski Patrol Experience:
Location: Total Yrs Patrolled:
Currently active?
What is your point of contact on the patrol or mountain (if any)?
Why do you see yourself as a potential patroller?
What are your Job Interests and Hobbies?
Please visit our web site to review the costs, benefits and requirements of patrol membership. If you would like to take the next step, fill out this form, and the web cowboy or sidekick will contact you with the patrol orientation schedule. Thanks for your interest... this is the highest volunteer opportunity you'll experience!