MEMBERSHIP APPLICATION
_____________________________________                    Type of Membership:  (Check One)
NAME
_____________________________________                ___ Member (Age 18+)   $25.00 per year
ADDRESS
_____________________________________                ___ Jr. Member (17 & under)  $10.00 per year
CITY/STATE/ZIP
_____________________________________                ___ Family (includes youth)   $40.00 per year
HOME PHONE (Parent(s) and youth under 17)
_____________________________________
WORK PHONE


Please list all members included in this membership application:
            NAME                                                                        AGE:
            _____________________________________________________________________
            _____________________________________________________________________
            _____________________________________________________________________
            _____________________________________________________________________


Check areas of interest:
            ___  Trail Rides                          ___    Youth Events (___Flag Team; ___4-H)
            ___  Versatility Events             ___     Educational Seminars
            ___   Showing                            ___    Horse Show Management
 

Enclose check and mail completed application to:
DeDe Marshall
240 Loblolly Lane
Ellerbe, NC 28338
(910) 652-2153

All memberships expire December 31 each year. Exception: new members who join in October, November or December

Rev. 09/02