ILLINOIS PAINT HORSE ASSOCIATION

2008 MEMBERSHIP FORM

 

Please send to: Rita Hankins, 600 S. Bartlett Road, Bartlett IL 60103

 

 

Name______________________________________________________________

 

Address____________________________________________________________

 

City_________________________State_____________Zip___________________

 

Phone_______________________Email___________________________________

 

Type:  Youth ($10)         Single ($15)     Family/Farm ($20)

 

List children’s names, birthdays and APHA Youth numbers below:

 

          Name                                      Birthdate                           APHA Youth Number

 

          _______________________       _______________     _________________

 

          _______________________       _______________     _________________

 

          _______________________       _______________     _________________

 

          _______________________       _______________     _________________

 

New for 2008: APHA membership is required for all exhibitors to show.

List individual’s names and 2008 APHA numbers for those who will be showing this year.

 

          Name                                                  APHA Number

 

          ______________________________          ______________________

 

          ______________________________          ______________________

 

          ______________________________          ______________________

 

          ______________________________          ______________________

 

Laminated “Permanent” Numbers-$5 each:

We sell permanent numbers each year with all proceeds going to the IL Youth Club. If you would like to purchase numbers for 2008, please indicate what number(s) you would like below and include $5 for each one you choose. If that number is available, we will have it laminated and available for pick up at the first show.  If you had bought one in 2007, that number will be available to you for purchase again until July. If it’s not re-purchased, it will be released. 

 

    Number(s) requested:                                                         

 

______________________________________________________________________

 

                  Membership fee: $___________

 

             Permanent # fee(s): $___________

 

Total amount enclosed:$__________­­­­­­_____     Check #: ____________