SASKATCHEWAN BLIND SPORTS ASSOCIATION and CANADIAN BLIND SPORTS ASSOCIATION

Volunteer MEMBERSHIP APPLICATION FORM 2011-2012

 

Please ensure this information is correct and complete; indicate any changes in the appropriate area.

 DATE OF APPLICATION: ___________________________________

                                                                        PERSONAL INFORMATION

NAME:

 

 

ZONE:

 

ADDRESS:

 

 

MALE:

 

CITY/PROVINCE:

 

 

FEMALE:

 

POSTAL CODE:

 

 

DATE OF BIRTH:

 

PHONE NUMBER:

 

 

MEMBERSHIP #:

 

E-MAIL ADDRESS:

 

 

                                                                                AREA OF DISCIPLINE

BOWLING

  

 

LAWN BOWLS

 

CURLING

 

 

POWERLIFTING

 

GOALBALL

 

 

OTHER

 

GOLF

 

 

INACTIVE

 

 

                                                                SIGHT CLASSIFICATION (Only Athletes to complete)

 

B1 (Total)

 

 

B2 (Low Partial)

 

 

B3 (Partial)

 

 

Please list any NCCP (National Coaches Certification Program) courses you have completed. 

 

 

 

 

Please indicate:  if you prefer INDIVIDUAL or HOUSEHOLD (one copy of mail-outs will suffice for all members within your household); or by E-MAIL;

 

Individual

 

 

Household

 

 

E-Mail

 

      

 

Membership Fee for 2010-2011 is $10.00.  You automatically become a member of Canadian Blind Sports Association (CBSA).

Please make cheque payable to                    SASKATCHEWAN BLIND SPORTS ASSOCIATION

and return along with this Form to                 510 CYNTHIA STREET

                                                                   SASKATOON SK  S7L 7K7

 

Your Application will be processed by the SBSA Office. 

 

 

SASKATCHEWAN BLIND SPORTS ASSOCIATION and CANADIAN BLIND SPORTS ASSOCIATION

athlete MEMBERSHIP APPLICATION FORM 2011-2012

 

Please ensure this information is correct and complete; indicate any changes in the appropriate area.

 DATE OF APPLICATION: __________________________________________________________

                                                                           PERSONAL INFORMATION

NAME:

 

 

ZONE:

 

ADDRESS:

 

 

MALE:

 

CITY/PROVINCE:

 

 

FEMALE:

 

POSTAL CODE:

 

 

DATE OF BIRTH:

 

PHONE NUMBER:

 

 

MEMBERSHIP #:

 

E-MAIL ADDRESS:

 

 Please check one of the following that is most applicable to your Aboriginal ancestry.

STATUS/TREATY ________        NON-STATUS ________        METIS ________        INUIT ________

                                                                                    AREA OF DISCIPLINE

BOWLING

  

 

LAWN BOWLS

 

CURLING

 

 

POWERLIFTING

  

GOALBALL

 

 

OTHER

 

GOLF

 

 

INACTIVE

 

 

SIGHT CLASSIFICATION (Only Athletes to complete)

 

B1 (Total)

 

 

B2 (Low Partial)

 

 

B3 (Partial)

 

 

Please list any NCCP (National Coaches Certification Program) courses you have completed. 

 

 

 

 

Please indicate:  if you prefer INDIVIDUAL or HOUSEHOLD (one copy of mail-outs will suffice for all members within your household);

if you prefer newsletters by AUDIO or by E-MAIL;

 

Individual

 

 

Household

 

 

Audio

 

 

E-Mail

 

 

Membership Fee for 2011-2012 is $10.00.  You automatically become a member of Canadian Blind Sports Association (CBSA).

Please make cheque payable to                    SASKATCHEWAN BLIND SPORTS ASSOCIATION

and return along with this Form to                 510 CYNTHIA STREET

                                                                  SASKATOON SK  S7L 7K7

 

Your Application will be processed by the SBSA Office. A Membership Card will be issued upon request.

 

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