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					                             Old Dominion Miniature Horse Club

I/We desire to become a member of the Old Dominion Miniature Horse Club of Virginia (ODMHC) and have enclosed
with this signed application the annual fee based on the appropriate membership, made payable to Old Dominion
Miniature Horse Club. If this application is accepted, I/We agree to comply with all terms and regulations as set forth in
the rules and By-Laws of ODMHC.

Membership Application

Members Name:                                                                              AMHA#                         Expires
                                                                                           AMHR#                         Expires

2nd Family Member:                                                                         AMHA#                         Expires
        (18yrs or older)                                                                   AMHR#                         Expires

        Regular Member Individual with (1) vote           $25.00
        Regular Member Family with (2) votes              $35.00
        Junior Member* no voting privilege                $10.00
        Associate Member** no voting privilege            $ 5.00

Farm Name:
Address:
City:                                         State:                                      Zip Code:
Telephone:                                    Cell Phone:                                 E-mail:
Website: www.

Date:


* Junior members are considered youth 17 and under and can be from household but must fill out a membership
application to be documented as to where they reside and for general information for ODMHC
**Associate member is an individual member 18 years or older who subscribe to the Articles of the club. Ownership of a
Miniature Horse is not required

You must be a voting member to be eligible to participate in the Virginia Bred Program and Futurity Nominated
Program.

Annual membership shall start January 1st and end December 31st. Dues will be due by January 15th of the new fiscal
year. There will be a $10 additional late fee for each month the membership is delinquent.

By E-mail and PayPal
At this time you can fill in this form and save it, then email it as an attachment to odmhc@olddominionminiaturehorseclub.com
You can pay using the paypal button next to this form on the forms page.
By Mail
                             If you prefer you can fill in this form and send a check made out to ODMHC and mail it to
                                                                           ODMHC
                                                                  12712 Port Republic Rd
                                                                 Grottoes, Virginia 24441
                                                                  c/o Bill Hollar Treasurer

				
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