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| Bluegrass Pleasure And Walking Horse Association Post Office Box 568, Richmond, KY 40476 606-271-0381 Application for Membership (Membership runs from January1 until December 31) Types of Membership: Family $25.00____ Individual $15.00_____(check one) Name:________________________________________________________________ Children’s names:(under18)______________________________________________ Mailing Address:_______________________________________________________ City:___________________________________State:__________Zip Code:_______ HomePhone:_______________________________Barn:_______________________ Office:____________________________________Cell:________________________ Email:_____________________________________________________(please print) Signature:_____________________________________________Date:___________ For Office Use Only Date accepted:_____________ Membership number:__________________ |