FNAME:*
LNAME:*

ADDRESS1: *
ADDRESS2:
CITY:              *
STATE:          *
ZIP:                 *
COUNTRY:

PHONE:     *
FAX:          
EMAIL:    *

* These areas must be filled out

All Membership packages include membership card and its privileges, Friends of Tuckerman poster, bumper sticker decal, seasonal newsletter, free parking shuttle.

Ski Area 10-Year Support $1000
You get: 200 Posters, which you can sell for $5 or more and get your money back, links to web page and membership packet.

Summit Life Time Family $850
Membership packet and signed copy of Nick Howe's book "Not Without Peril", FOTR hat.

Summit Life Time Individual $550
Membership packet and signed copy of Nick Howe's book "Not Without Peril", FOTR hat.

Ravine 5-Year Family $175
Membership packet, FOTR hat.

Ravine 5-Year Individual $120
Membership packet, FOTR hat.

Friend 1-Year Family $50
Membership packet.

Friend 1-Year Individual $35
Membership packet.

Student Friend 1-Year $25
Membership packet.

SELECT TYPE OF REGISTRATION TYPE:

Please Choose Ski Area 10-Year Support $1000 Ravine 5-Year Family $175 Ravine 5-Year Individual $120 Friend 1-Year Family $50 Friend 1-Year Individual $35 Student Friend 1-Year $25 Summit Life Time Family $850 Summit Life Time Individual $550 *

MASTERCARD OR VISA ONLY*

CC NUMBER:
EXP DATES:
VCODE: this is the 3 digit security code found on the back of the card.

*IF YOU DO NOT WANT TO PROVIDE THIS INFORMATION THEN PLEASE CALL US WITH IT AND WE WILL PROCESS YOUR MEMBERSHIP AS AN ONLINE MEMBERSHIP SO YOU CAN QUALIFY FOR THE LIFT TICKET. CALL 603-356-0131