2009 MEMBERSHIP APPLICATION
To apply for 2009 membership
of the Capricorn Horse Riders Inc please complete either the Individual
or Family Membership portions and return to
Capricorn Horse Riders Inc.,
or
fax (07) 4992 6043 or email
by
the 28th February 2009.
Individual
Membership - $5.00
Name: ________________________
Address:
_______________________
______________________________
Ph: __________________________
Email:
________________________
Family Membership -
$10.00
Name
1:________________________
Name
2: _______________________
Name
3: ______________________
Name
4: ______________________
Address:
_______________________
______________________________
Ph: __________________________
Email:
________________________
¨ I
have enclosed payment
OR
¨ I
have made a direct deposit into the Capricorn Riders Inc. bank account
BSB: 034 805 A/C: 100712770
(please use your last name as a reference if using this payment method).