Maple E Miniature Horse Society
Membership Application
Name____________________________________Phone________________
Farm Name_______________________________________________________________
Address_______________________________________State______Zip___________
Email Address___________________________________________
Individual: $25
1 adult, all
mailings1 vote on all issues
$______
Farm: $30
2 adults, unlimited
youths, all mailings, 2 votes on all issues
$______
Youth Only: $10
1 youth, all
mailings No voting rights
$______
SPONSORSHIP
Class(es) at $20 per class____________________________________
$______
Championship Class(es) at $30 perclass_________________________________ $______
Total $______
Youth Members Name & DOB
_______________________________ _______________________________
Signature
of Parent/Guardian if under 18
____________________________________________
Are you interested in volunteering for any committees
1 Yes
1No
If yes, which committees 1Shows/Clinics 1 Fund Raising 1 Membership Drives
Would you like to be listed on the club web site
1 Yes
1 No
Make checks payable to Maple E Miniature Horse Club (MEMHS)
Mail checks to Diana Fiorey, 21 Carpenter Road, Surry
NH 03431
