FCEA Membership Form
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Name *
DOB (required for JR and Masters)
MM
/
DD
/
YYYY
Age Group *
Address *
City *
State *
Zip *
USDF#
Home Phone
Cell/Work Phone
Email Address *
Trainer/Instructor
Addt'l Family Member Name
Addt'l Family Member DOB (required for JR and Masters)
MM
/
DD
/
YYYY
Addt'l Family Member USDF#
 Addt'l Family Member Age Group
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To be eligible for year end awards members must complete volunteer requirements. If you have a preference, what volunteer activity would you prefer?
What are your interests *
Required
Would you like to be listed on the Member Services Directory of the FCEA Website? Please list services(s) provided (ie:Boarding, Instruction, Braiding, Trailering, Farriers, etc.), website, and if different from above contact information.
Would you allow FCEA to give your email address to approved Sponsors? *
How would you like to receive club news? *
Membership Type *
*Jump Start Membership may join starting 9/1 and benefits continue thru the following year. Allows late joining new members to get a jump start on membership benefits. **Education Sponsors are not considered members of the club, but are allowed to participate in unmounted activities. They must pay non-member fees for FCEA shows and clinics.
Required
How are you sending payment? *
Checks payable to FCEA, Mail to: Louise Jordan-Beam 85 Williams Rd, Douglassville, PA 19518
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