Page 10 - HBHA 2021 Directory Book
P. 10

HBHA Membership Form
                               Heartland Buckskin Horse Association Membership Application
                                           (International Buckskin Horse Charter)

                                                        Circle One:

        1 year memberships:          Single $15            Family $25           Youth $5

        Lifetime memberships:        Single $45            Family $75

                                  **Single year memberships expire 12/31 of every year.**
        **Once a youth family member turns 19 they need to purchase their own membership**

        Year: _______________

        Name(s):__________________________________________________________________________________

        __________________________________________________________________________________________
        __________________________________________________________________________________________


        Address:__________________________________________________________________________________

        __________________________________________________________________________________________

        Phone Numbers: ____________________________________________________________________________

        Email:____________________________________________________________________________________

        Birthdates: ________________________________________________________________________________


                                           Please makes payable to HBHA and send to:
                                                      Niome Zeisneiss
                                                                th
                                                      18612 670  Ave
                                                      Nevada IA 50201
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