Date:  _________________

 
Name: ___________________________________________________________________________

 
Address: _________________________________________________________________________

 
City/State/Zip: ____________________________________________________________________

Telephone:______________________________   Email/Fax:______________________________

Membership Available:  Indicate which you would prefer: (circle one)

 *Founders Membership- Lifetime  (family) - $100                  *Individual Membership: Annual  -  $20

 *Family Membership: Annual -  $25                                    *Business Sponsorship:

Do you currently own any Foundation Horses?: Yes  or  No

 Breeder?:  Yes or No                     Interest in clinics?  Yes  or  No

 Interest in cutting?  Yes or No        Interest in team roping?  Yes or No

 Interest in Showing?  Yes  or  No    Assist with Show Organization?  Yes  or No

Make Check payable to:  Arizona Foundation Quarter Horse Club

 Send to:  Mike Dean, 14201 East Highway 169, Dewey, Arizona  86327                                                      

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