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Temporary Membership Application Summary Instructions: **Show Management Must Complete and Forward This Form to APHA with Show Results

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Temporary Membership Application Summary Instructions: **Show Management Must Complete and Forward This Form to APHA with Show Results Temporary Membership Application Summary Instructions: **Show management must complete and forward this form to APHA with show results. **List all APHA memberships applied for at the show. **Keep a copy for your records and send original to APHA. APHA APHA APHA APHA APHA ID # Membership fee Membership fee Membership fee Membership fee Name City, State (if known) *1 year--$40 *3 year--$90 *5 year--$150 *Lifetime -- $500 $ Amount Paid Total $ Date of show: Show location City, State Show secretary signature: Horse Show Office Use Only: APHA Temporary Membership Application Show #: _____________________ Date: ________________________ Location: _____________________ American Paint Horse Association City, State P.O. Box 961023 u Fort Worth, Texas 76161-0023 (817) 834-APHA (2742) u Fax (817) 222-8489 COMPLETE APPLICATION IN FULL www.apha.com Omitting information will delay processing All exhibitors must be current APHA/AjPHA individual members in order to the eligible to show. For an AjPHA membership, please fill out a Temporary Youth Application. Proof of individual membership is required at time of showing. Membership Name: _____________________________________ Birth Date (Required for Youth 18 & Under): _____________________ Were you a member in the past? o Yes o No If yes, what was your member ID#: __________________________________ Address: ______________________________________________________________________________________________________ City: _______________________________________________________ State: ____________ Zip: _________________________ Phone: _____________________________________________________ Email: __________________________________________ Method of Payment: o Cash o Check/Money Order o VISA o MasterCard o American Express o $40 – Annual Membership o $90 – 3-year o $150 – 5-year o $500 – Lifetime Return to the show secretary with appropriate fees payable to APHA. All payments must be made in U.S. Funds only. If you pay by check, your check may be converted into an electronic funds transfe r. __________________________________ ________________________________ ______________________ ______________ Credit Card Number Name on Credit Card Expiration Date CVV# ______________________________________________________________________ ______________________________________________________________ Signature Phone s Show Location: Show #: Show Secretary Signature: Show Secretary: State: City: Address: ____________________________________________________________________ Membership Name: ___________ _______________________________________________________________ __________________________ ____________________________________________________________ _______________________________________________________ ______________________________________________________ Zip: ______________ ______________________________________________ Fax (817) 222-8489 u Date: Country: City, State City, ____________________________ Fort Worth, Texas 76161-0023 Texas Fort Worth, www.apha.com u _________________________ Valid for 45 days Valid upon receipt of completed application. upon receipt Temporary Temporary American Paint Horse Association Horse American Paint *Permanent membership will be issued by APHA P.O. Box 961023 P.O. Membership Card (817) 834-APHA (2742) ext. 773 s 2015 Membership Card Examples 1. Barrel Racing, Goat Tying, Pole Bending, Stake Race 1. Barrel Racing, Goat Tying, Pole Bending, Stake Race 2. Western Riding 2. Western Riding 3. Jumping, Working Hunter 3. Jumping, Working Hunter 4. Pleasure Driving, Utility Driving 4. Pleasure Driving, Utility Driving 5. Showmanship 5. Showmanship 6. Breakaway Roping, Tie-Down Roping, Heading, Heeling, Steer Stopping 6. Breakaway Roping, Tie-Down Roping, Heading, Heeling, Steer Stopping 7. Western Pleasure 7. Western Pleasure 8. Hunter Under Saddle 8. Hunter Under Saddle 9. Horsemanship 9. Horsemanship 10. Hunt Seat Equitation 10. Hunt Seat Equitation 11. Trail 11. Trail 12. Team Penning, Ranch Sorting 12. Team Penning, Ranch Sorting 13. Hunter Hack 13. Hunter Hack 14. Reining 14. Reining 15. Working Ranch Horse 15. Working Ranch Horse 16. Cutting 16. Cutting 17. Hunt Seat Equitation Over Fences 17. Hunt Seat Equitation Over Fences 18. Cowboy Mounted Shooting 18. Cowboy Mounted Shooting 19. Dressage 19. Dressage 20. Working Cow Horse 20. Working Cow Horse 21. Ranch Pleasure 21. Ranch Pleasure *Note: You must be eligible per Rule AM-205.A. in order to compete in the following *Note: You must be eligible per Rule AM-205.A. in order to compete in the following categories. The categories you are eligible for are noted on the front of this card. categories. The categories you are eligible for are noted on the front of this card. APPROVED NOVICE CATEGORIES APPROVED NOVICE CATEGORIES 1. Barrel Racing, Goat Tying, Pole Bending, Stake Race Note: You must be eligible per Rule YP-205.A. in order to compete in the following 2. Western Riding 3. Jumping, Working Hunter categories. The categories you are eligible for are noted on the front of this card. 4. Pleasure Driving, Utility Driving 5. Showmanship 1. Barrel Racing, Goat Tying, 11. Trail 6. Breakaway Roping, Tie-Down Roping, Heading, Heeling, Steer Stopping Pole Bending, Stake Race 12. Team Penning, 7. Western Pleasure 8. Hunter Under Saddle 2. Western Riding Ranch Sorting 9. Horsemanship 3. Jumping, Working Hunter 13. Hunter Hack 10. Hunt Seat Equitation 11. Trail 4. No Classes Offered 14. Reining 12. Team Penning, Ranch Sorting 13. Hunter Hack 5. Showmanship 15. Working Ranch Horse 14. Reining 6. Breakaway Roping, 16. Cutting 15. Working Ranch Horse 16. Cutting Tie-Down Roping, Heading, 17. Hunt Seat Equitation 17. Hunt Seat Equitation Over Fences Heeling, Steer Stopping 18. Cowboy Mounted Shooting Over Fences 19. Dressage 7. Western Pleasure 18. Cowboy Mounted Shooting 20. Working Cow Horse 21. Ranch Pleasure 8. Hunter Under Saddle 19. Dressage *Note: You must be eligible per Rule AM-205.A. in order to compete in the following 9. Horsemanship 20. Working Cow Horse categories. The categories you are eligible for are noted on the front of this card. NOVICE YOUTH CATEGORIES 10. Hunt Seat Equitation APPROVED NOVICE CATEGORIES 21. Ranch Pleasure.
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