Dedicated to the enjoyment and promotion of the American Paint Horse

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Membership Form  

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FREE - A painting by Debbie Scott

Sato- Owned and photographed by True Colours Farm

LIPHC Membership Application

 Name:_____________________________APHA#_______

 Street Address:  __________________________________

 Town: ____________________State __  Zip: ______

 Phone: ____________     E-mail: _____________________

__ Adult Individual                         $25.00 

___ Junior Individual   (18 & under)         $15.00    Please give age:__  

Date of Birth: _______ (juniors only)         

_____ Family                                $30.00   Please list all family members & ages of children

 ___________________               ____________________

 ___________________               ____________________

 ___________________               ____________________

 ___________________               ____________________

Memberships are valid January 1^st thru December 31^st.

 Make checks payable to:  Long Island Paint Horse Club, Inc.

 Mail to:            LIPHC

                        PO Box  1615

                        Riverhead, NY 11901-0900

 Members are entitled to all club activities, newsletters, voting privileges and the recording of LIPHC show points for the current year from the time membership payment is received.  All owner(s) must be members of LIPHC to receive year-end awards.