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MEMBERSHIP APPLICATION    

Name(s)____________________________________	Class of Membership applied (Circle One)
___________________________________	Individual       $20
Street     ___________________________________	Family            $30
City/State/Zip _______________________________	Trainer:  Individual $20    Family $30
Phone (_____)_______________________________	Vendor     $75
Contact (Vendor) ____________________________
Minors (Family) ______________________________

  

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Membership year is October 1 through September 30 or any portion thereof.  Membership dues are payable in advance and are non-refundable.  Checks should be made payable to Mid America PFHA
 
  PRINT FORM AND MAIL THIS COMPLETED APPLICATION WITH YOUR CHECK TO:     Mid America Membership c/o Pascale Smith, WindWalker Paso Finos P.O. Box 241031 Apple Valley, MN  55124