2024 MQHA Membership Form

2024 MQHA Memberships:

Individual Membership $35.00

Family Membership $45.00

NOTE: A family membership consists of two adults and youth aged children all residing in the same household

MQHYA Membership (Youth Association) - $5.00 per Youth in addition to regular membership cost.

Lifetime Membership $350.00

Application Type*

NewRenewal

Membership Type*

Individual Application ($35.00)Family Membership ($45.00)MQHYA Membership (ADD $5.00 per youth)Lifetime Individual Membership ($350)

Member Details

	Last Name	First Name	Date of Birth (Youth Only)	Youth Membership	Category
Member #1
Member #2
Member #3
Member #4
Member #5
Member #6

Address*

Address

Street Address Line 2

City

Prov*

Postal Code*

Phone Number

Email (membership card will be sent here, please allow up to 7 days)*

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

Date

PAYMENT METHOD

Credit Card (3.5% Surcharge will be applied)E-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 Sarah Boss
72 Meeting House Rd., Upper Onslow, NS B6L 5J1

My Products - If paying by credit card a 3.5% surcharge will be added.