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If you wish to join our club, simply print this form, complete and mail to address at the bottom. Thank you!
| Your Name(s) | _______________________________________________________ |
| Farm Name (optional) | _______________________________________________________ |
| Address | _______________________________________________________ |
| City, State, Zip | _______________________________________________________ |
| Phone Number | _______________________________________________________ |
| E-mail Address | _______________________________________________________ |
| Website Address | _______________________________________________________ |
Other Family Members to be included: Children Under 18 Years of Age
| Name | Age | Date of Birth |
|---|---|---|
| ______________________________________ | _________ | ______________ |
| ______________________________________ | _________ | ______________ |
| ______________________________________ | _________ | ______________ |
| ______________________________________ | _________ | ______________ |
| ______________________________________ | _________ | ______________ |
Please put a check mark by the appropriate membership:
| _______ | $25.00 for either an Individual or Family Membership. This includes a one-year subscription to the MMHC bi-monthly Newsletter, a club information pack, and voting rights. A new member joining after October 1st will be a fully paid member through December 31st of the following year. |
| _______ | $10.00 for a Junior Membership (a person under 18 years of age, if there is no paid family membership). Junior Members 10 years of age and older will receive the MMHC bi-monthly newsletter. |
| _______ | $20.00 for a one-year subscription only to the MMHC bi-monthly newsletter. |
| _______ | $10.00 Member Business Card Ad for year. |
Please indicate if membership is:Make check payable to: Minnesota Miniature Horse Club - Mail to:
_____ Membership Renewal (due by January 25th)
_____ New MembershipKaren Mellenberndt
1931 Cloud Dr.
Blaine, MN 55449**If you DO NOT want your names/information published on the MMHC Website, please indicate this
request by printing your name on this line_______________________________Questions?? Send email to: k.mellenberndt@worldnet.att.net
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