Walkaloosa Horse Association
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Walkaloosa Horse Association Membership Application
You can send this information via the web, or complete, print, and mail this Membership application to:
Walkaloosa Horse Association
P.O. Box 3170
Carefree, Arizona 85377 
NOTE: When mailing in a Membership application it must be accompanied with a signature or it will not be processed.

 
Type of Membership: 
12-month membership.......USD......$25
36-month membership.......USD......$60
Life membership.................USD......$400 
Name
(required if not using a Business Name
and no more than 30 total characters)
Business Name
(required if not using an Individual Name
and no more than 30 total characters)
Address
(required)
Address Continued
(optional)
City
(required)
State/Province
(required)
Postal Code
(required)
Ext. (+4)
(optional)
Country
(required)
E-mail Address
(required)
Home Phone
(required)
Work Phone
(optional)
Date of Birth MM/DD/YY
(required)
 

From time to time, WHA sends e-mail important to Members about events and other promotional news. Please indicate whether or not you would like to receive these e-mail messages from WHA.
Yes, I would like all information that WHA sends out via e-mail in the future.
Yes, I would like information about my Membership and WHA business, but no promotional information.
No, I do not want any information that WHA sends out even if it concerns my Membership status.
        Billing Information:
Name Appearing on Front of Credit Card
(required)
Type of Credit Card
(required)		 VISA
MasterCard 
Credit Card Number
(required)
Credit Card Expiration Date
(required)
Billing Address
(required)
Billing City
(required)
Billing State
(required)
Billing ZIP Code
(required)		 EXT.(+4)
Billing Country
(required)

 
 
IMPORTANT:PLEASE READ BEFORE PROCEEDING
Membership in Walkaloosa Horse Association ("WHA") shall be active only upon payment of fee and acceptance of a membership application by WHA. 
NOTE: When mailing in a Membership application it must be accompanied with a signature. Please ensure that all the fields are completed and filled in with the appropriate information. If any fields are left blank or contain incorrect information your application cannot be processed. 
BY SIGNING BELOW, I ACCEPT the rules and regulations relating to Membership in WHA and affirm the truth of all statements above.
Signature Date
Mail this Membership application to: 
Walkaloosa Horse Association
P.O. Box 3170
Carefree, Arizona 85377 
Additional Information:

(Limited to 200 words,)

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