Great Lakes Quarter Horse Association
5811 Evergreen St.
Midland, MI 48642
(989) 835-5815 Phone
(989) 835-4703 Fax

MEMBERSHIP APPLICATION
Please print out and fill in appropriate blanks. Make sure you include a check for the proper amount

DATE of APPLICATION:_____________________

NAME:________________________________________________________________

ADDRESS:_____________________________________________________________

CITY:__________________________________STATE:__________ ZIP:___________

TELEPHONE: (________)___________________________________

Please Check Choice of Membership Below:

( ) $40.00 Single Membership (Canadian membership is $50.00 in US Funds)

( ) $45.00 Family Membership: This includes one individual plus spouse or other member of the
immediate family. The other family member must have attained the age of sixteen years, be
unmarried, and reside in the same household. Include an additional $10.00 for each family member
you wish to add other than the two members covered by the $45 fee. List names of persons to be
added as members below. All family members have one vote each. (Canadian membership is $55 /
US Funds).

(Spouse)________________________________________________________________

(Child)__________________________________________________________________

(Child)__________________________________________________________________

( ) $45.00 Partnership / Corporation (one vote & list voting member below) (Canadian membership
is $55.00 in US Funds)

(Name of voting member)________________________________________________

( ) $300.00 Life membership.

*All persons nominating horses for Great Lakes Quarter Horse Association races will be required to pay
membership dues at the time of the first nomination.
All members will receive a GLQHA Calendar and GLQHA By-Laws
Memberships expire on January 1st of each year.

Please make check payable to: Great Lakes Quarter Horse Association (GLQHA)

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