Michigan Paint Horse Club 2009 Membership Application
Memberships run from January 1st thru December 31st of each year.

 
 
Member's Name
APHA # DATE OF BIRTH
All amateur and youth exhibitors must supply complete date of birth.
ADDRESS
CITY STATE ZIP
PHONE # EMAIL

FILL IN FOR FAMILY MEMBERSHIPS
SPOUSE'S NAME APHA#
DATE OF BIRTH Amateur and youth exhibitors must supply COMPLETE DATE OF BIRTH.

CHILDREN'S NAME APHA # DATE OF BIRTH

NOTE:  Children have to be 18 or under as of January 1st and be a child of the member or spouse to be included in family memberships.  If over 18, or not a child of the member or spouse, they must have an individual membership of their own.


I AGREE TO ABIDE BY THE MPHC RULES AND REGULATIONS.
Signature Date

 

IF YOU DO NOT WISH TO HAVE YOUR NAME AND ADDRESS PUBLISHED PLEASE CHECK HERE
IF YOU DO NOT WISH TO HAVE YOUR PHONE NUMBER PUBLISHED PLEASE CHECK HERE  
IF YOU DO NOT WISH TO HAVE YOUR EMAIL ADDRESS PUBLISHED PLEASE CHECK HERE

MAKE CHECKS PAYABLE TO MPHC.

Mail check, application and copy of your horse's papers to: M.P.H.C
c/o Diane Kliemchen
12431 Flynn Rd
Sawyer, MI 49125

IMPORTANT REMINDERS:  Please be sure your membership application reads the same as your registration papers.  For example, if both husband’s and wife’s names are listed as owners on the registration papers, then both must be members (family) for the points to count toward year end awards.  If two individuals with both names on the papers, you must both have individual memberships.

ALSO, a copy of your horse’s papers must be on file with the point secretary before any points will be counted for year-end awards, so be sure to include with your application and check. See year-end rules for details.

FOR OFFICE USE ONLY: CHECK #______________________ TAB SHEET (BACK #) __________
DATE RECEIVED/POSTAGE DATE _____________________