Membership Application

Like to become a member of Fjordings West? You will receive our quarterly newsletter,
invites to special events, discounts on member products and services, and voting priveleges.
Just print this page, fill it out and mail it with payment to: Fjordings West c/o Deb Keevy,
Treasurer, 5940 E. Gerard Ave, Merced, CA 95340. Dues are $18 single/couple (includes 1
vote) or $25 family per year (includes 2 votes). Pro-rate dues after July 1st are $10
single/couple or $15 family.

Primary Member Name: ______________________________________

Additional Family Members: ___________________________________

Farm Name: _______________________________________________

Mailing Address: ___________________________________________

Phone #: _____________________ Email: _______________________

How many Fjords do you own? ________________________________

Circle your interests:

RIDING... ENGLISH- PLEASURE DRESSAGE JUMPING

WESTERN- PLEASURE REINING

DRIVING... PLEASURE DRAFT/FARM CDE

BREEDING...

TRAIL RIDING... "JUST FOR FUN" ENDURANCE CTR

OTHER? _________________________________________________

Fjordings West Committees. Be an active part of our group -- please circle the committees
you would like to join.

HORSE SHOWEVALUATIONADMINISTRATION

BOARD OF DIRECTORS