PO Box 442 DORRIGO NSW 2453
Phone: (02) 6657 5342
ABN 23 131 758 362
APPLICATION FOR MEMBERSHIP
PLEASE PRINT ALL DETAILS CLEARLY
NAME OF MEMBERSHIP: ________________________________________________________________
(required for Joint Membership applications only)
POSTAL ADDRESS: _____________________________________________________________________
_______________________________________________________ STATE ________ POSTCODE ______
RESIDENTIAL ADDRESS: _________________________________________________________________
_______________________________________________________ STATE ________ POSTCODE ______
PHONE NO: ________________ FAX NO: ________________ EMAIL: _____________________________
I hereby apply to become a member of the Guy Fawkes Heritage Horse Association Inc. If my application is approved, I hereby agree to be bound by the Constitution and Rules and Regulations of the Guy Fawkes Heritage Horse Association Inc currently in force and as amended from time to time.
SIGNATURE: ______________________________________________________ DATE: ___/___/________
If the applicant is under 18, the signature of a parent or guardian is also required.
MEMBERSHIP TYPE AND FEES
MEMBERSHIP TYPE | AMOUNT (inc GST) | TICK APP BOX
| |
| = $66.00 |
| |
|
| = $55.00 |
| |
|
| = $11.00 |
| |
| Stud Prefix (once only fee) | = $11.00 |
|
NOTE FOR INTENDING BREEDERS: If you intend to breed Guy Fawkes Heritage Horses, you will need a Joint or Single membership and apply for a Stud Prefix and Brand with the association. Firstly you must contact your relevant State Authority to register your brand, (in NSW this is your local Rural Lands Protection Board), to ascertain what brands are available to be used THEN submit it to the GFHHA Registrar.
PROPOSED STUD PREFIX: First choice ________________________________________________
Second choice ______________________________________________
Third choice ________________________________________________
|
|
All stock brands must be registered with the relevant State Authority as per their requirements; proof of such registration is required.
I __________________________________________ a member of the Guy Fawkes Heritage Horse Association Inc. nominate the applicant, who is personally known to me for membership of the Association.
SIGNATURE: ______________________________________________________ DATE: ___/___/________
Please forward this application form and your cheque/money order for the appropriate amount to: