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Southern Regional Paso Fino Horse Association
Membership Application
___New Membership ____Renewal Membership
Name:______________________________________
Address:___________________________________
___________________________________________
Home PH:_______________________
Farm PH:_______________________
Fax:_______________________________________
Email:______________________________________
Membership Type
Are you listed as a SRPFHA member with
PFHA?___
___Individual Membership (18 yr +) ...$15.00
___Associate Membership ...$10.00(non PFHA members or PFHA voting members with another region)
___Junior Membership (under 18 yr) ...$ 5.00
___Family Membership ...$25.00 (includes husband, wife and juniors in same household)
....Name:_________________________PFHA#______
....Name:_________________________PFHA#______
....Name:_________________________PFHA#______
....Name:_________________________PFHA#______
Do you want your name and ph. number listed in our membership directory? _______
Do you want to list your occupation and business in our newsletter? ______
Occupation:___________________________________
Company:______________________________________
Address:______________________________________
PH:___________________________________________
Would you like to join our committees?
Check you choices.
_____Parades and Promotions
_____Membership
_____Trail Rides
_____Meetings
_____Clinics
_____Show
Would you like to hold an office?_____ Office:____________
Print out this form, complete and return
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