2009 West Coast Pintabian Horse Association
Membership Application
www.westcoastpintabians.com
Family Membership (Please list all joining family members living in the same household) (up to 5 members)
First name_________________________________Middle________________Last___________________________________
First name_________________________________Middle________________Last___________________________________
First name_________________________________Middle________________Last___________________________________
First name_________________________________Middle________________Last___________________________________
Ranch/Farm Name_______________________________________________________________________________________
Mailing Address________________________________________________________________________________________
City______________________________________________________ State_____________ Zip Code___________________
Email________________________________________________ Website__________________________________________
Phone number __________________________________________Cell phone_______________________________________
Interests:
□ Western Pleasure
□ English Pleasure
□ Trail Riding
□ Reining/Cow horse
□ Jumping
□ Dressage
□ Breeding
□ Showing
□ Other_________________
□ Other_________________
What type of activities would you like to see WCPHA promote? __________________________________________________
Family Membership dues are $25.00 per calendar year.
Please make check payable to: WCPHA and send along with membership application to:
WCPHA, 20516 Bertone Drive, Fiddletown, CA 95629
| Signature(s)______________________________________________ ________________________________________ |
| ________________________________________________________ ________________________________________ |
| ________________________________________________________ |