Membership Form

Year
New Application Individual Membership ($30) Individual Membership ($30) Family Membership ($40)Family Membership ($40) MQHYA Membership - add $5 per youthMQHYA Membership - add $5 per youth Lifetime Individual Membership ($300.00) NOTE: A family membership consists of two adults and youth aged children all residing in the same household

Please indicate the division of everyone using the category codes as follows:
Application Type*

NewRenewal
Membership Type*

Individual Application ($30)Family Membership ($40)MQHYA Membership ($5.00 per youth)Lifetime Individual Membership ($300)

Member Details

Address*

Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Prov*
Postal Code*
Phone Number
Email*
example@example.com
The MQHA is committed to ensuring the privacy of its member's personal information. The information provided on this form allows the MQHA to inform you about events and activities and to notify you of issues, events or special offers which may be of interest to you. By becoming a member, you are giving the MQHA permission to contact you by way of the information you have provided. The information on our membership list will be kept confidential and is only made accessible to members of the MQHA Board of Directors in order to conduct MQHA business and will not be available for outside commercial purpose. By signing this form you agree to these terms on behalf of yourself and any other family members listed above.
Signature

Clear
Date

MonthDayYear
Date
PAYMENT METHOD

OnlineE-TransferCheque
Membership applications will be processed upon receipt of the appropriate fees. Make cheque payable to: Maritime Quarter Horse Association

Payments can by etransfer to maritimequarterhorse@gmail.com, paid online (credit card fees extra) or by cheque to Maritime Quarter Horse Association C/O Jonathan Melong 2662 Route 106 Hwy, Boundary Creek, NB, EIG 4M3
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