LAST NAME _____________________________FIRST______________________ RANK_______
ADDRESS_________________________________________ LAST 4 DIGITS OF SS#___________
CITY__________________________________________STATE______ZIP CODE______________
PHONE ________-________-________ EMAIL___________________________________________
Period of QuarterHorse service:
Please indicate: W.W.II Vietnam Cold War Desert Storm Peace Time Iraq
1st Date of service with the Quarter Horse:
Troop __________Platoon ____________________Section___________
From __________/__________to __________/__________
2nd Date of service with the Quarter Horse:
Troop __________Platoon ____________________ Section.___________
From __________/__________to _________ /__________
Total number of years in Armed Services___________
Please indicate:
Veteran Troopers..........$25.00 Per Year
Active Duty Troopers......$10.00 Per Year (AD Combat Veterans-1st Year Free)
Spouse or Child of Deceased Trooper....$15.00 Per Year
Live Membership for Veterans.....Age 50 and below: $150.00
51 - 55: $140.00
56 - 60: $130.00
61 - 65: $120.00
66 - 70: $110.00
71 and above: No Charge
Membership Card will be mailed within 30 days via U.S. mail to the above address.
Membership information will not be made available to third parties without your
permission..
Enclosed is my check or money order payable to the "Society of the Quarter Horse."
in the amount of $________.
Please sign _________________________________________ Date_____________________
Mail this completed application to:
Treasurer
Quarter Horse Society
6645 122nd Ave.
Fennville, MI 49408