Great Lakes Quarter Horse Association glqha.com
5811 Evergreen Street
Midland, Michigan 48642
(989) 835-5815
Dinner reservations due by 12/15/06
Print this form - Fill out and Mail Today! - Mailing instructions at bottom of the form
Convention\Registration Form
NAME:_______________________________________ PHONE:__(_____)_____________________
ADDRESS:_________________________________________________________________________
Number of Dinners____@ $25.00 each (includes $5.00 Registration Fee)
Total Enclosed $_______ (NO dinner tickets will be sold at the door)
A $5.00 Registration Fee must be paid by everyone attending the Convention (included in dinner tickets)
We would appreciate your donating a door prize: ( )Yes, I will bring a Door Prize
( ) Please accept my check donation and purchase a
door prize on my behalf. Amount donated $_________
Mail To: Tammy Lewis 6447 14 Mile Road Rockford, MI 49341
Telephone: (616)-696-1032
Attention Horsemen - We need each other!
Join GLQHA Today! All Members receive:
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