PDF File of this Form HERE                                PA Palomino Exhibitors Association                                                                                           Membership Application/Renewal Note: FULL PPEA MEMBERSHIP & VOTING PRIVILEGES NOW REQUIRES A 2003 PHBA NATIONAL MEMBERSHIP in each name with PPEA listed as your state affiliate. Click on link for "Membership " & please be sure to list "PPEA" as your Affiliate Palomino Assn. For fastest service please enclose a copy of your 2003 PHBA Card(s). Applicants with no PHBA membership or with another club listed with PHBA as their primary affiliate will be Associate PPEA Members. PPEA Regular, Youth, or Associate Membership Dues $10.00 per year per person listed (adult or youth). New _______  Renew _______  Date _____________ Name(s)                                                                   PHBA ID#                 Date of Birth (if amateur or youth) ________________________________   ______________  ___________________  ____________ ________________________________   ______________  ___________________  ____________ ________________________________   ______________  ___________________  ____________ ________________________________   ______________  ___________________  ____________ ________________________________   ______________  ___________________  ____________ Number of individual people (names) listed above _____________ @ $10 each = $ __________ I (we) wish to donate $ _______ per person to the PHBA Video Fund to help promote the Palomino.                                       Optional -- ($1 suggested contribution per person) $ __________                                       Make Checks payable to PPEA         Total enclosed $ __________     Your Address __________________________________________   County ____________________  City  ____________________________________  State __________________  Zip _____________  Phone _________________________________    E-mail __________________________________ Do you own any Palominos? ___ yes ___ no Current PHBA or PHA member? ___ yes ___ no Which? _______________ Primary State Palomino Affiliate Club as registered with PHBA, if not PPEA  ____________________ Horse activities in which you participate: ___ stand stallion(s) ___ breed mares ___ show horses ___ other (list below)   Please list any talents, special skills, expertise, or information you'd be willing to share to help PPEA; and any suggestions, ideas, or comments you have about our Palomino organization: (attach extra sheet if needed)  Thank you, and welcome to PPEA!     Please use one form for each household/mailing address · Mail this form with your dues check to:  MARY BETH KUZNIK,    PPEA Secretary,    6093 Pleasant Valley Road,    Irwin PA 15642 Please make checks payable to PPEA                  724-744-3345                           ppea@pahorse.net

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