Type (Required)
Expedite Application
Enhanced Magazine Delivery Options
Include your name and mailing address on a list occasionally sold by USPA? (USPA does not sell member's e-mail addresses)
Applicant's Name (First, Middle and Last):
USPA License Numbers (complete if Renewing or Rejoining Member):
USPA Membership Number:
Year membership expired:
Total number of years as a USPA member:
USPA wants to provide you with the services you want and the representation you need. To do this, we need a few statistics. Please take a moment to answer some important questions:
What is your profession?
Gender
Date of birth (month/day/year)
Total sport jumps in the last 12 months:
Total sport jumps to date:
Have you attended a USPA Safety Day in the last 12 months?
Malfunctions in the last 12 months:
Number of skydiving injuries requiring treatment in a medical care facility in the last 12 months: