Kansas Buckskin Horse Association

KANSAS BUCKSKIN HORSE ASSOCIATION MEMBERSHIP APPLICATION

Name ________________________________ Phone _________________________

Address _______________________________________________________________

Zip _________________ New Member ______ Renewal __________ Date __________

Youth __________________ Birth Date ________________ ABRA ID # ___________
.......__________________ .............._______________...............____________
........__________________............. _________________ ...........____________

ABRA Amateur (Name) _________________ and Number _______________________

E:Mail Address ______________________________

Individual Membership $20.00 ____________
Family Membership (Includes children under 19) $25.00 ____________
Farm/Partnership or Corp Membership $25.00 ____________
Late fee for renewals received after March 31 $ 5.00 ____________

Make Checks Payable to: KBHA
Mail to Cathy Webster, 39407 Harmony Road, Fontana, KS 66026