RENEWAL
The Ohio Quarter Horse Association
MEMBERSHIP APPLICATION/RENEWAL Name: __________________________________________________________________________ AQHA # ____________________________ Name must appear exactly as on your AQHA membership.
Address: _________________________________________________________________ Year Membership Desired: 20_________ City:_____________________________ State: _____________ Zip Code: ____________ Phone: (_______) ______________________ Birthdate ________/______/________
E-mail: ________________________________________________________________
Check Membership Type: Amateur Membership $25 Adult Membership Regular Membership $15 Youth Membership- Birthdate: ______/______/______ $60 Family Membership * (please complete Family Information below) $250 Life Membership I would like to: $_______ Donate to the Ohio Quarter Horse Foundation Scholarship Fund $_______ Donate to the Ohio Quarter Horse Foundation Crisis Fund $_______ Donate to the Ohio Quarter Horse Foundation Equine Welfare
$ _____________ Total (amount enclosed/and or charged)
Payment Method:
Check/Money order enclosed
Visa/Master Card/American Express/ Discover
Fees are the discount for cash and check paying customers. Credit card charges will require a 3% convenience fee.
Credit Card #: Signature:
Exp. Date:
Security Code:
* Complete This Section For Family Memberships Only Name
must appear exactly as on your AQHA membership
________________________________ ________________________________ ________________________________ ________________________________
Membership Reg/Youth/Am
____________ ____________ ____________ ____________
Relation
___________ ___________ ___________ ___________
Birthdate AQHA #
___________ ___________ ___________ ___________
___________ ___________ ___________ ___________
E-mail
_________________________________ _________________________________ _________________________________ _________________________________
Please view the OQHA Rule Book online at OQHA.COM
Send completed form and payment to:
OQHA / Attn: Mindy Westlake PO Box 209 • 101 Tawa Rd. • Richwood, OH 43344 [email protected] • 740-943-2346 ext. 123 Fax: 740-943-3752
Please note: OQHA memberships are not valid until payment is received. Memberships are on a calendar year basis and will expire December 31st of the year joined. Memberships must be received in the OQHA office by September 1st of the current year for voting privileges. No memberships will be accepted over the phone.
MEMBERSHIP APPLICATION/RENEWAL Name: __________________________________________________________________________ AQHA # ____________________________ Name must appear exactly as on your AQHA membership.
Address: _________________________________________________________________ Year Membership Desired: 20_________ City:_____________________________ State: _____________ Zip Code: ____________ Phone: (_______) ______________________ Birthdate ________/______/________
E-mail: ________________________________________________________________
Check Membership Type: Amateur Membership $25 Adult Membership Regular Membership $15 Youth Membership- Birthdate: ______/______/______ $60 Family Membership * (please complete Family Information below) $250 Life Membership I would like to: $_______ Donate to the Ohio Quarter Horse Foundation Scholarship Fund $_______ Donate to the Ohio Quarter Horse Foundation Crisis Fund $_______ Donate to the Ohio Quarter Horse Foundation Equine Welfare
$ _____________ Total (amount enclosed/and or charged)
Payment Method:
Check/Money order enclosed
Visa/Master Card/American Express/ Discover
Fees are the discount for cash and check paying customers. Credit card charges will require a 3% convenience fee.
Credit Card #: Signature:
Exp. Date:
Security Code:
* Complete This Section For Family Memberships Only Name
must appear exactly as on your AQHA membership
________________________________ ________________________________ ________________________________ ________________________________
Membership Reg/Youth/Am
____________ ____________ ____________ ____________
Relation
___________ ___________ ___________ ___________
Birthdate AQHA #
___________ ___________ ___________ ___________
___________ ___________ ___________ ___________
_________________________________ _________________________________ _________________________________ _________________________________
Please view the OQHA Rule Book online at OQHA.COM
Send completed form and payment to:
OQHA / Attn: Mindy Westlake PO Box 209 • 101 Tawa Rd. • Richwood, OH 43344 [email protected] • 740-943-2346 ext. 123 Fax: 740-943-3752
Please note: OQHA memberships are not valid until payment is received. Memberships are on a calendar year basis and will expire December 31st of the year joined. Memberships must be received in the OQHA office by September 1st of the current year for voting privileges. No memberships will be accepted over the phone.
