Application for Membership

(To use this Application, first print it using your printer and then complete all the questions. Mail the completed form, along with appropriate payment, to: Mid-Eastern Farrier's Association, c/o Michael McNutt, 1077 Fitzgerald Lane, New Concord, Ohio 43762 USA.)

Name: __________________________________________

Phone number: ____________________________________

E-mail address: ____________________________________

Street Address: ____________________________________

City: ______________________ State: ______ Zip: ______________

Optional - Spouse's Name: ___________________________

Annual Dues: $30.00

Are you a: ______ Full Time Farrier ______ Part-Time Farrier ______ Veterinarian

Other - Explain: __________________________________________

Please mail the completed form, with appropriate payment, to the address indicated above.

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