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P.O.

Box 1032
Elgin, SC 29045
Membership Application

Name__________________________________ AQHA ID_____________Exp________

Address_________________________________________________________________

_________________________________________________________________

Email __________________________________________________________________

Phone__________________________________

Desired Membership
You must be a member of SCQHA to earn SC points for state year end awards in Open,
Amateur and Youth. Youth members must be from a Family Membership

Membership Options: Amount Paid

SCQHA Family (to include all youth) $45 ________________

SCQHA Individual (no youth) $35 ________________

Names of all members that show and date of birth. Please include address if different.

______________________________________AQHA ID___________DOB_______

______________________________________AQHA ID___________DOB_______

______________________________________AQHA ID___________DOB_______

______________________________________AQHA ID___________DOB_______

All Memberships expire on 12/31 of year applied. Mail application to PO Box 1032,
Elgin, SC 29045

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