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Membership Application
Name
First Name *
Last Name *
Address
Country
Address Line 1
Address Line 2
City
State/Province
Postal Code
Phone (Home)
Phone (Cell)
Phone (Work)
AQHA ID #
Your Points will be kept by AQHA number.
Must be complete for points to count
.
Are you a Novice?
Yes
No
A first-time member of LQHA?
Yes
No
Email
Membership Level
Life/Any Division $200
Open or Amateur $35
Youth/Open $25
Youth Information
Birthday
Age Group
13 & Under
14 thru 18
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Parent/Guardian
Amateur Information (Must have birth date)
Birthday
Surcharge
An additional {transaction_fee} will be added to cover the cost of this transaction.
Surcharge
Your total payment will be
.
every month
until you cancel the recurring agreement.
Your credit balance will cover
Your credit card will be charged
Your bank account will be charged
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Home
Sponsorships
Our Sponsors
Become a Sponsor
Get Connected
About Us
Our Mission
Board Members
Committees
Become a Board Member
Rules and Regulations
Contact Us
News & Shows
What's New
Show Schedule
Member Points
Photo Gallery
Important Links
Members
Become a Member
Renew Your Membership
Member Points
Membership Forms
Youth Members & Scholarships
Hall of Fame
Hall of Fame Nomination Form
Hall of Fame Horse Nomination Form
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