Membership Form for the
Michigan Hackney / ASPC / AMHR Association

Name:__________________________________________________________

Address:_________________________________________________________

City:________________________State:_______________________________

Telephone:________________________________________________________

Farm Name:_______________________________________________________

E-mail:____________________________________________________________


Family: ________  Individual:_______Youth________

Cost for Family: $15.00           Individual: $10.00         Youth:  $5.00       


My Division

Hackney______Shetland______Mini Horse_____American Show Pony______

Mail form to:

James Bruggink
7136 Homerich Ave. S.W.
Byron Center, Michigan 49315

Make checks payable to:  Michigan Hackney / ASPC / AMHR  Assn.
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