SKYDIVERS OVER SIXTY – S.O.S.

Please Print
NAME:

Application date:_____________________

POPS #:____________________________

Life-time membership fee:$10.00

Send to:

Pat Moorehead, SOS #1

3350 St. Francis Place

Long Beach, CA 90805-3854

 

562-630-5229

skyfunone@aol.com

 

For office use only: SOS# _____________

                            

Membership date: ____________________

 

Dues Paid:$ _________________________

 

Additional US Team donation:$ _________

Street:

City:

State/Province:

Country& Postal Code:

E-Mail:
**Please notify the SOS Office of ANY above 'address' changes**

DATE OF BIRTH:

NUMBER OF JUMPS: (optional)

 

20070131