Name*
First Name Last Name
Email*
Enter your email address Confirm your email address
Address
Civic number, street City Province Postal Code Country
Contact phone number
Intrawest/Embarc Membership Number
For each purchase of points, please indicate the location of purchase, the date and the number of points acquired
Purchase 1
Place Date Points
Purchase 2, if applicable
Place Date Points
Purchase 3, if applicable
Place Date Points
Did you sell some or all of your points prior to or in 2007?*
- Yes
- No
If yes, please indicate the date of the sale
Date
Did you sell some of all of your points after 2007?*
- Yes
- No
Please indicate any additional information about your situation
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Place	Date	Points

Place	Date	Points

Place	Date	Points

For each purchase of points, please indicate the location of purchase, the date and the number of points acquired