Old
Dominion Morgan Horse Association
2011 Membership Form
$20.00
Individual Membership
$30.00 Family (Parents + U-18)
$8.00 Jr. Member (U-18 non-family)+
$10.00 Student (18-22 Full
time students)+
$8.00 Active Youth*
*Must be member of AMHA.
+No Voting privileges.
For Additional Membership Info Contact:
Elizabeth Strohman (estrohman@embarqmail.com)
16020 Pine View Lane
Beaverdam, VA 23015
(804) 227-3720
Name(s) Adult Members: _______________________________________
Name(s) and Birth Dates of
Junior/Student Members: _______________________________________
Farm Name: _________________________________________________
Address: ____________________________________________________
__________________________________________________
Telephone: __________________________________________________
E-Mail address: _______________________________________________
Comments on farm:
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
Horse 1: Name:________________________________For sale Y/N
Sire and Dam: ___________________________________________
Registration#:________________Color: ______________________
Year Born: ______________________Height:__________________
Sex: __________________________
Horse 2: Name: ________________________________For sale Y/N
Sire and Dam: ___________________________________________
Registration#:________________Color: ______________________
Year Born: ______________________Height:__________________
Sex: __________________________
Horse 3: Name: ________________________________For sale Y/N
Sire and Dam: ___________________________________________
Registration#:________________Color: ______________________
Year Born: ______________________Height:__________________
Sex: __________________________
Horse 4: Name: ________________________________For sale Y/N
Sire and Dam: ___________________________________________
Registration#:________________Color: ______________________
Year Born: ______________________Height:__________________
Sex: __________________________
Horse 5: Name: ________________________________For sale Y/N
Sire and Dam: ___________________________________________
Registration#:________________Color: ______________________
Year Born: ______________________Height:__________________
Sex:__________________________
If more space needed, use back.
Circle ones that apply:
Breeding Boarding
Instruction Hunter
Mare and Foal Care
Instruction Carriage driving Stock
for Sale
Instruction Dressage
Trailering
Instruction Eventing
Stallion Service
Instruction Western
Instruction Saddleseat
Instruction Trail
Instruction Show Driving
Instruction English Pleasure
Instruction Over Fences
Training Hunter
Training Carriage driving
Training Dressage
Training Eventing
Training Western
Training Saddleseat
Training in Hand
Training Trail
Training Show Driving
Training English Pleasure
Training
Over Fences
