Reinstatement Process Form Step 1 of 250%Nationwide Reinstatement PolicyThe following reinstatement process gives former PSIA-AASI members a path to return to activecertified membership. The reinstatement process provides former members a path to return toactive membership without loss of their prior certification level. The reinstatement process can occur at any time during the year and is standardized for all disciplines.This process is not required if educational units are current at the time of reinstatement.Members also have the option of going through the certification process if they would likeanother way to become an active certified member.Reactivation:1-Year Membership Lapse Members who have missed a year of membership dues will be required to paylast year’s membership dues (+ late fee) as well as the current year’smembership dues and continue to follow CEU requirements.2-4 Year Membership LapseMembers will be required to pay a $200 reinstatement fee as well as the currentyear’s dues.Members will be required to earn 6 CEUs for each year they have not paid dues.Members who wish to become an inactive certified member must fulfillguidelines for inactive members.The person’s membership card will indicate updated status.Recertification:5 Years or More Lapsed Membership:Members will be required to pay a $300 reinstatement fee as well as the currentyear’s dues.Members will be required to earn 24 CEUs within two seasons. Members will beresponsible for working with – and getting approval from – their division fortheir personal recertification plan.The person’s membership card will show inactive certified status until theirpersonal recertification plan is complete.*Individuals wishing to re-join PSIA-AASI can do so as an Alumni member if they meet qualifications or as a Registered Member.Name* First Last Email* Member ID #Primary Phone*Primary Phone Type*CellHomeWorkOtherAlternate PhoneAlternate Phone TypeCellHomeWorkOtherAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Date of Birth MM slash DD slash YYYY How shall we follow up with you?*EmailPhoneEither is fine Reinstatement Circumstances*Inactive Member Wishing to go Active AgainInactive Member Wishing to go to Alumni StatusAlumni Member Wishing to Regain Certification1 Year of Lapsed MembershipTwo to Four Years of Lapsed MembershipFive or More Years of Lapsed MembershipPlease choose which is closest to your current circumstances regarding your reinstatement.Your Primary Discipline*AlpineAdaptiveSnowboardTelemarkCross CountryHighest Certification Level*Level 1Level 2Level 3Date of Last Membership* MM slash DD slash YYYY Snowsports SchoolSnowsports School Director's NameMembership Summary*Please provide some details about your past membership. (Including your past join date if at all possible.)Additional InformationIs there any additional information about your prior membership, which might be helpful in considering your application?