NWAFTHBA
MEMBERSHIP FORM
2009
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