Staff Status Inquiry

This form allows your ski school to inquire about the certification level and dues payment status of your
staff. Please fill out the form with your employees’ names and mail or fax back this form to the PSIA – C
office. To better service your ski school, please make sure that each name is spelled correctly and
legibly.

SKI SCHOOL: ________________________ CONTACT: __________________________________

ADDRESS OR FAX # TO RETURN FORM TO: __________________________________________

________________________________________________________________________________

Staff Name Certification Level Current on PSIA – C Dues

MAIL OR FAX THIS FORM TO THE FOLLOWING:

PSIA – C, 3225 West St. Joseph, Lansing, MI 48917
FAX: (517) 321-0495