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WQHA / WQHYA Membership Application
For Current Calendar Year January 1 to December 31

Start Enjoying the Benefits of Membership Today!
Membership in the Wisconsin Quarter Horse Association Offers:
The WQHA Newsletter including an annual Directory  ~  Breeders and Open Futurities and Maturities  ~  Open Show Awards Program  ~  Annual Convention and Year-End Awards
Affiliation with the AQHA and the Wisconsin State Horse Council  ~  Scholarship Program
In order to earn WQHA points toward year-end awards, one must be a member of the Wisconsin Quarter Horse Association (both owner and exhibitor of horse)

** denotes required fields

Select New or Renewal:  **      New        Renewal
Address Change

Select membership Type:  **
               Single  $30.00
               Family  $35.00
               Partnership, Farm, or Corporation   $35.00
               Life - Single  $275.00
               Life - Family  $275.00
               Life - Partnership, Farm, or Corporation  $275.00

Last Name:   **
First Name:   **
Middle Name:
AQHA ID Number:   **
Name 2 (if Family membership or Partnership):
AQHA ID Number Name 2 (if Family membership or Partnership): 
Address:   **
City:   **      State:   **       Zip:   **
Telephone: ()-  **
E-mail: 
Birth Date (if 18 or under):  month/day/year

If Family Membership list names and birth dates of children under 18 years of age:
Child 1 Name:  Last:   First:   Middle:
Child 1 Birth date:  month/day/year     AQHA ID Number: 

Child 2 Name:  Last:   First:   Middle:
Child 2 Birth date:  month/day/year     AQHA ID Number: 

Child 3 Name:  Last:   First:   Middle:
Child 3 Birth date:  month/day/year     AQHA ID Number: 

Child 4 Name:  Last:   First:   Middle:
Child 4 Birth date:  month/day/year     AQHA ID Number: 

Child 5 Name:  Last:   First:   Middle:
Child 5 Birth date:  month/day/year     AQHA ID Number: 

 

Payment: **
               Check
                    Make checks payable to:
                    WQHA
                    W2056 Tecumseh Road
                    New Holstein, WI  53061
               Credit Card
                    Credit Card Number:
                    Credit Card Expiration Date: 

   

Thank You Very Much

WQHA    Schedule of Events    Membership    WQHA Point Counts    Amateur

Youth   Visit Our Friends    Classified Ads    Members Pages

Last modified: Sunday, January 24, 2010

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