| NAME: |
| STREET or RR #: |
| CITY:
PROVINCE:
POSTAL CODE:
PHONE: |
| TYPE OF MEMBERSHIP: (2009 FEES) (CIRCLE ONE)
LIFE: $500.00 FAMILY $100.00 SINGLE: $50.00 ASSOCIATE: $40.00 |
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DATE: SIGNATURE: |
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CHEQUE OR MONEY ORDER (in Canadian Funds) PAYABLE TO: Canadian Trakehner Horse Society
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