BC Paint Horse Club - Online Membership Application Form

BCPHC - Online Membership Application Form



Membership Type

◙ New Membership or Renewal?
◙ Membership Type

Family memberships: Maximum of 2 adults, no limit to Juniors. All family members must reside at the address submitted on the Application form. *Junior memberships: 18 years of age or under as of January 1, 2010. Junior members do not have voting privileges.



Membership Names

◙ Adult # 1
APHA NUMBER (If Applicable)

◙ Adult # 2
APHA NUMBER (If Applicable)

◙ Junior# 1
BIRTHDAY
APHA NUMBER (If Applicable)

◙ Junior# 2
BIRTHDAY
APHA NUMBER (If Applicable)

◙ Junior# 3
BIRTHDAY
APHA NUMBER (If Applicable)



Contact Information

◙ Farm or Ranch Name (If Applicable)
◙ Mailing Address
◙ City
◙ Province / State
◙ Postal / Zip Code

◙ Primary Phone Number
◙ Fax Number

◙ Adult 1 e-mail address
◙ Adult 2 e-mail address
◙ Junior 1 e-mail address
◙ Junior 2 e-mail address
◙ Junior 3 e-mail address

◙ Website Address (If Applicable)



Fees and Payment

◙ How Will You Be Paying?
◙ Western Horsemanship Magazine?

Make cheques payable to the "BC Paint Horse Club" in Canadian funds. If you have any questions please contact Dianne at 604.530.3366 or by e-mail lazy3@telus.net Mail cheques to: BC Paint Horse Club c / o Dianne Rouse 421 240th Street Langley, BC V2Z 2X5



Submit Application

Your Membership will not be finalized until payment has been received.




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