VPHC and VjPHC 2019 membership form
NOTES: 1)For a membership to be considered effective, payment must be received. Address to mail the payment is listed at the bottom. 2)To participate in the VPHC election and to receive up to date info on VPHC and APHA in periodic News Notes and Newletters, you must supply an email address.
If you’d like to pay your 2018 VPHC or VjPHC membership online, you can do so at the following link: http://www.virginiapainthorseclub.org/membership.html

Rates for online membership payments (to cover PayPal fees) are as follows:

VPHC Individual $21
VPHC Family/Farm $36.50
VjPHC annual $11
VjPHC term (expires 12/31 of 18 year-old year) $52

NAME & APHA ID#:
Your answer
FARM NAME(only if family/farm membership):
Your answer
ADDRESS:
Your answer
PHONE#:
Your answer
EMAIL-personal and farm:
Your answer
TYPE of MEMBERSHIP:
PLEASE LIST YOUTH MEMBERS: name, DOB, AjPHA#
Your answer
INDICATE AREAS of INTEREST:
Please make checks payable to VPHC Mail to: Jennifer Johnson PO Box 5 Drewryville, VA 23844 jdjohnson63@msn.com vphconline@gmail.com
Your answer
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