OQHA Membership Application

Please print out this form, complete it, and provide a check or money order payable to OQHA for the amount of your membership, and mail to:

The Ohio Quarter Horse Association
Membership Department
101 Tawa Rd., P.O. Box 209
Richwood, OH 43344-0209

Please note: OQHA memberships are on a calendar year basis and will expire December 31 of the year joined.

Name_________________________________________________________________________

(first)

(middle initial)

(last)

 Address____________________________________________________ City__________________________
State_______________ ZIP CODE_______________ Phone(_____)__________________
Year membership desired________ Youth birthdate_________(month/day/year) SS/Fed ID_____________________
Names
(family memberships only)
Member type*
(Regular, Amateur, Youth)
Member's relationship,Youth birthdate and age
_____________________________ __________________________ ____________________________
_____________________________ __________________________ ____________________________
_____________________________ __________________________ ____________________________
_____________________________ __________________________ ____________________________
(*For membership type, you can also use abbreviations REG for adult, AM for amateur, andYTH for youth)
Check the appropriate box for your OQHA membership type:  
$40.00 family membership $20.00 regular membership Do you have internet access?
$10.00 youth membership check if you are an amateur yes no
$150.00 life membership  email address_______________________________________________________