INDIANA THOROUGHBRED OWNERS AND BREEDERS ASSOCIATION

MEMBERSHIP  APPLICATION

Fill out and Mail to:

ITOBA

P.O. BOX 252

BEECH GROVE,  IN   46107

Name_______________________________________________________________________

Farm/Company________________________________________________________________

Address______________________________________________________________________

City______________________________________State___________Zip__________________

Home Phone____________________Work____________________Fax___________________

E-Mail________________________________Website ________________________________

Do you stand a stallion?  ________    Stallion name: ___________________________________

Do you own boarding facilities?  _______  training facilities?  ______  breeding facilities? ______

Are you a thoroughbred trainer?  _________    Are you currently racing thoroughbreds?  ________    

In which states do you race?  _____________________________________________________

Are you currently breeding thoroughbreds? ______  In which states?  ______________________

DUES (please circle one):

One Person, One Year:           $ 50.00

One Person, Three Years:         $ 125.00

One Person, Lifetime:          $ 500.00

 Joint Membership, One Year:          $ 80.00

(Joint Membership:  Husband and Wife at Same Address:  PLEASE LIST BOTH NAMES ABOVE)

Please make checks payable to: ITOBA

Please make checks payable to: ITOBA or pay by credit card:

 

Credit Card #:  _________________________________________     Exp. Date: ____________

Code:  ___________   Signature:  __________________________________________________

 

Membership