ISHR MEMBERSHIP APPLICATION
2120 Scotch Hollow Rd., Noel, MO. 64854 / 1-866-201-3098 / 1-417-475-MARE
NAME:_____________________________________________________ DATE:____________ PHONE:______________________
ADDRESS:______________________________________ CITY:_______________________ ST/PROV:__________ ZIP:________
Membership Wanted: Y___ N___ Annual Membership: $12.00 Y___ N___ Lifetime Membership: $100.00 Y___ N___
EMAIL ADDRESS: - Optional: __________________________________________________________________________________
Email Newsletter Subscription (annual): FREE MEMBER #:__________________
Branch(s) In Which You Will Be Registering Horses In: Paint/Pinto___ Appaloosa___ Pintaloosa___ Other___ None___
TOTAL AMOUNT ENCLOSED FOR ABOVE: $___________________ U.S. FUNDS ONLY PLEASE
(IF PAYING WITH PAYPAL PLEASE ADD A 7% CONVENIENCE FEE TO TOTAL)