APPLICATION

Print and mail with check to AWWA P.O. Box 136, Barksdale, Tx 78828

ARABIAN WORKING WESTERN

ASSOCIATION MEMBERSHIP

APPLICATION

NAME:__________________________________DATE:___________
ADDRESS_____________________________________________________
CITY _____________________________STATE______ ZIP____________
SPOUSE / DUAL NAME__________________PHONE:________________
OFFICE:____________FAX____________E-MAIL___________________
FARM NAME__________________________________________________
MEMBER'S SS #_______________MEMBER’S DOB_________________
IAHA #____________________DUAL MEMBER’S DOB_______________
DUAL MEMBER’S IAHA #__________DUAL MEMBER’S SS#__________
Type of membership (check)
    ____ Individual $60.00
    ____ Family $60.00 1 vote (circle name of adult family member whose name is to be submitted to IAHA. DOES NOT INCLUDE IAHA YOUTH MEMBERSHIP)
    ____ Spouse/Dual $110.00 2 votes
    ____Associate $30.00 no vote, adult
    ____Youth (17 and under) $12.00 1 vote in YIAHA
List juniors under 18: Name                                                  DOB
                                      _______________________________________
                                      _______________________________________
                                      _______________________________________
You may be a full affiliate member of more than one club.

Has your membership in any Arabian horse association been terminated by action of the respective association? ____ If so, please explain

I agree to abide by the Constitution and Bylaws of the ARABIAN WORKING WESTERN ASSOCIATION and to uphold them.

Signature of applicant(s):_______________________________________________
                                         _______________________________________________
Signature of Parent or Legal Guardian for Youth member:_____________________________
Make all checks payable to ARABIAN WORKING WESTERN ASSOCIATION and return to
JIM BAKER PO BOX 136 BARKSDALE, TX 78828 1-830-234-3146

FAX: 1-830-234-3147 e-mail: awwainc@netscape.net

http://sites.netscape.net/awwainc

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