American Saddlebred Versatility Association

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VERSA Application

Name of VERSA Applicant

Membership Application Status

New

Renewal

Check here if you are under age 18

Mailing Address

City/State/Province/Zip Code

Preferred Phone Number

E-mail Address

Favored Disciplines

Member of Other Charter Clubs

yes

Name of ASHA Charter Club(s) you belong to (Refer to ASHA website for a list of charter clubs.)

NOTE: If you are a member of an ASHA charter club, dues to join VERSA as a Sr. Member are reduced to $10.

Type of Membership (check one)

Senior Member Dues $20

Senior Member Dues $10 (if eligible)

Junior Member Dues $10

I am using PayPal to pay my dues.

I am mailing my check for payment of dues.

NOTE: Mail check to Treasurer - Hattie Francis, 2251 N. McGuire Lane, Columbia, MO 65202

I am a Member of ASHA

yes

ASHA Member Number

Message

IT'S A WIN WIN! When you join VERSA, note that you are eligible for lower VERSA *dues of $10 when you are a senior member of an ASHA Charter Club. If you are a VERSA member, you are eligible for a lower ASHA membership fee.

JOIN VERSA AND PARTICIPATE!

Instructions: Complete the Membership Application contact form on this page and submit. You can then use the PayPal option below to pay your dues or you can mail a check to the treasurer. If you prefer a paper application click here.

Membership Dues

The Membership Year is from December 1 to November 30.