NWAFTHBA
MEMBERSHIP FORM
2005
 

Family Membership $ 25.00  ___        Single Membership $15.00  ___ 
(includes children 17 & under)

Associate Membership $15.00  ___
(non-horse owning,  non-voting)



NAME:   _________________________________________________

ADDRESS:   ______________________________________________

__________________________________________________________

HOME PHONE:   __________________________________________

WORK PHONE:   __________________________________________

E-MAIL ADDRESS:   ______________________________________

SPOUSE NAME:   __________________________________________
 
CHILDREN (UNDER 18):   ________________________________


COMMITTEE INTERESTS:  (check all that apply)
 

YOUTH PROGRAMS ___     NEWSLETTER ___     PROMOTIONS ___

SHOWS ___     CLINICS ___     TRAIL RIDING ___     OTHER _____________
 

SUGGESTIONS: _______________________________________________________


 MAKE CHECK PAYABLE TO:  NWAFTHBA

MAIL APPLICATION & CHECK TO:

LORA DECKER

14076 E. HWY 94 SPUR

ROGERS, AR  72758


MEMBERSHIPS ARE RENEWABLE ON JANUARY 1 EACH YEAR