NICHA

Northern Illinois Cutting Horse Association

NICHA 2010 MEMBERSHIP APPLICATION.

Please complete the following items. The application must be filled out completely to be processed correctly

Thank you for your clear and precise information

Name: ___________________________________________   NCHA #: __________________________

Name: ___________________________________________   NCHA #: __________________________

                                (If Family)

Name: ___________________________________________   NCHA #: __________________________

                               (If Family)

Name: ___________________________________________   NCHA #: __________________________

                               (If Family)

Address: _____________________________________________________________________________

             (Street)                                             (City)                              (State)                 (ZIP)

Phone: _________________________     Home      Work    Cell   (Please circle one)

e-mail : _________________________ 

Please circlr one:

r Family $25.00r Single $15.00r Youth $10.00

Please make check payable to: NICHA.

Mail check and application to: Tim Barry p.o. box 510 Byron IL 61010

We would appreciate a copy of the horse/horses papers that you plan on showing in 2010, and a copy of your NCHA membership card.

Let's get ready to show!