NAME ______________________________________________MFTHBA membership #______________

SPOUSE _____________________________________________MFTHBA membership #______________

ADDRESS ____________________________________________________________________________

_____________________________________________________________________________________

PHONE NUMBERS ____________________________________________________________________

EMAIL ADDRESS ______________________________ WEB SITE______________________________

OCCUPATION(S) his ______________________________ hers_________________________________

NAME OF RANCH OR FARM ___________________________________________________________

Check all that apply: We offer   __training   __boarding   __breeding   __lessons   __farrier service

 __horses for sale   __trail riding   __tack for sale  other:___________________________________________________

I am interested in participating in the following committees: __Trail Ride __Show __Youth __Program/Activity

For renewals only:  I have been a member since ____________

Names and ages of children if family membership:________________________________________________________

_________________________________________________________________________________________________

Anything else you wish us to be aware of: ______________________________________________________________

A candidate for membership must be sponsored by a member in good standing whose personal signature must appear in the space provided below.

A check for the current year’s dues must accompany this application. (Applications received on or after November 1^st shall receive credit through the following calendar year.)

I, the undersigned, hereby apply for membership in the St. Louis Regional Foxtrotters, Inc. I agree to abide by the rules and regulations of said organization as stated in its by-laws and any amendments thereto. I agree, further, to conduct myself on all occasions in a manner consistent with and acceptable to the other members.

_____________________________________   __________________________________   _________
Signature of Applicant                                           Signature of Member Sponsor                          Date

Mail to Secretary, Carl Weidt   5768 Hwy N   Robertsville, MO 63092