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| Application for Membership ___ Individual $25.00 ___ Youth $10.00 ___ Family $35.00 |
Name: _______________________________ Date of Birth: __________________ Youth Only Address: ________________________________________ Apt./Floor: _____________ City: ________________________ State: __________ Zip Code: ___________ Phone Number: _______________________ (h) _______________________ (c) Fax: _________________________ Farm Name: _____________________________________ Email: __________________________________ Website: _______________________________________ Family Members Names (for family membership): __________________________________________________________ ___________________________________________________________________________________________________ Sponsor Name (for youth membership): _____________________________ Signature (parent or guardian if under 18): ___________________________________ Date: ____/____/_______ A Few Questions How many horses do you have? ___________ Do you: ___ Show ___ Breed ___ Keep as pets? Would you be interested in attending shows or clinics? ___ Yes ___ No Are you interested in volunteering for any committies? ___ Yes ___ No, thanks If yes, which committees? ___ Shows/Clinics ___ Website ___ Fund Raising ___ Membership Drives ___ Newsletters ___ Other: ___________________ How did you hear about the club? ___ Website ___ Flyer ___ Newspaper ___Media ___Show ___ A Friend (please list so we can thank them): ____________________________ ___ Other: __________________________________________________________ |
| Please print, fill out application, sign, and mail along with payment in the form of a check or money order to: Mary Frazier 4535 Emanuel Rd. Mt Pleasant, NC 28124 Please make checks payable to ECMHC. Be sure to retain a copy for your records. Thank you for your interest. We’re glad to have you join our group. |