Membership form for ES

Equestrian Society

Contents For Membership
Contact Info	Personal Info	H / P Names
News Letter	Comments	H / P / Discipline

Please Indicate Membership with a YES:

Half Member

Please provide the following contact information:

First Name

Middle Name

Last Name

Title

Organization

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Country

Time Zone

Work Phone

Home Phone

FAX

E-mail

URL

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Please identify and describe yourself:

Date of Birth

Sex

Marital Status

Age

Height

Weight

Hair Color

Eye Color

Education

Children at Home?

No Yes

Children's Ages:
(first 3, oldest to youngest)

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List the names of your Horses / Ponies..

1
2
3
4
5
6
7
8

If you have more than the 8, mail a list
of the others to admin@equestriansociety.org

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List the disciplines your Horse / Ponies compete in.

List the disciplines you as a rider only compete in.

1
2
3
4
5
6
7
8

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Would you like us to e-mail you the News letter?

Yes No
(Weekly)

Would you like us to post you the News letter?

Yes No
(Monthly)

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What do you think of new Society ?

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First Name
Middle Name
Last Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Time Zone
Work Phone
Home Phone
FAX
E-mail
URL

Date of Birth
Sex
Marital Status
Age
Height
Weight
Hair Color
Eye Color
Education
Children at Home?	No Yes
Children's Ages: (first 3, oldest to youngest)

Authors: Equestrian Society Copyright © 2008 by the World Sports Club Horse Society. All rights reserved. Revised: April 17, 2009

Authors: Equestrian Society Copyright © 2008 by the World Sports Club Horse Society.
All rights reserved. Revised: April 17, 2009