2012 Membership Application
Date of Application: _____________
Name: _____________________________________________
Address: ___________________________________________________
City: _______________________ State:_____________ Zip:______________
Phone:_______________________________________________________________ ( Required)
Email Address:________________________________________________________
Jr.'s DATE OF BIRTH:_____________________________
Adults: Amateur ____ Professional ____
Please check membership type:
Single $20.00 ___ Family $40.00 ___ Lifetime $200.00 ___
Please return membership applications with check payable to ETHJA to:
John Kearns
3015 West Gallaher Ferry Rd.
Knoxville, TN 37932
Remember to ensure you will be on the mailing list forms should be received no later than April 1st.
Notice: As of January 1st, 2004 ALL horses and ponies must be registered on a yearly basis, $10.00 annual fee, in order for points to be accrued.
