Indiana Saddle Horse Association
Membership Application
Name: _______________________________________________
Address:
City, State, Zip:
Home Phone: Work Phone:
E-mail:
Would you like to receive your Hoosier
Equestrian by E-mail? Y / N
New
Member Renewing Member
Single
$25.00 Affiliated Club—Individual $20.00
Family $30.00
Affiliated Club—Family $25.00
Membership $
Add Nomination Fees, if any, form second
page $
Total $
List
affiliated club
List names and ages of family members:
Membership includes One Year Subscription to the Hoosier Equestrian. Fill in the form
above, print and enclose check or money order made payable to: ISHA
Send form to: Indiana Saddle
Horse Association
8679 S. State
Road 243
Cloverdale, IN
46120-9696
For horse show purposes for the 2007 show season, a
rider’s age is determined by their age on December 1, 2006.
Nominating fee is $10 per division. List the
divisions you are nominating for by number.
Name of animal Divisions
Name of animal Divisions
Name of animal Divisions
Name and age of rider Divisions
Name and age of rider Divisions
Total # Divisions x $10.00 =