| Indiana Kentucky Illinois Miniature Horse Club, Inc. |
| Membership Enrollment Form Jan 1 - Dec 31, 2009 |
| Name __________________________________ __________________________________ __________________________________ __________________________________ __________________________________ __________________________________ __________________________________ __________________________________ |
| ___________________________________________ _________________ ______ ________ Street Address City State Zip ___________________________________________ _____________________________________ Home Phone Farm Name e-mail address________________________________ |
| Amount Paid $__________ by Check # __________ or Cash on__________. Single ($15) or Family ($20) Membership thru December 31, 2009 Please make your check payable to I.K.I., and send to: Margaret Brown, ShadowLand Farm, 2222 Fuquay Rd, Newburgh, Indiana 47630 If you have any questions, please call (812) 853-8224 The I.K.I. Miniature Horse Club thanks you for your support! |
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