USPHA Membership Application
United States Peruvian Horse Association
Membership Application
I hereby make application for Membership in the United States Peruvian Horse Association. I agree to abide by the By Laws and Rules and Regulations of the Association.
______ I qualify as an Owner/Breeder Member through the ownership of the following USPHA registered horse;
_________________________________ Name of USPHA Registered Horse
USPHA Registration No. ______
______ I am applying as an AFICIONADO Member so that I may support the goals and ideas of the USPHA even though I presently do not own a Peruvian Horse registered with the USPHA. I understand that I will not have the right to vote.
______ I have checked one of the above, and am a Junior under the age of eighteen (18).
Name__________________________________________________________________
Ranch Name: _________________________________________________________________
Address: _____________________________________________________________________
_____________________________________________________________________________
City: _________________________________________ State: _________ Zip: ____________
Primary Phone: _______________________________________________________________
Secondary Phone: _____________________________________________________________
FAX: _________________________________________________________________________
E-Mail: _______________________________________________________________________
Web Page URL: _______________________________________________________________
Signature: ____________________________________________________________________
RENEWAL ______ _____ NEW APPLICATION ______ Owner/Breeder $50 ______ Aficionado $25 ______ Junior $15
MAIL TO: USPHA - P.O. Box 249 - Morrison, CO 80465 Tele: 303 697-9567 www.USPHA.net
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