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Join CHC Today - Membership Application

Please select the appropriate membership type, as well as your preferences for E-mailed updates & newsletters, Boarding Stable Manager and directory listings.

$55.00 Insured Individual Membership (Begins 1/1/15; Expires 12/31/15)
$35.00 Insured Individual Membership - Mid Year (Begins today; Expires 12/31/14)
$105.00 Insured Family Membership (Begins 1/1/15; Expires 12/31/15)
$60.00 Insured Family Membership - Mid-Year (Begins today; Expires 12/31/14)
$85.00 Non-Profit, Club, Organization, Ranch or Corporate Membership
$25.00 Affiliate Membership*
$15.00 Fence Post Subscription - member rate
$15.00 American Horse Council Affiliate Membership
$0.00 YES! Please e-mail me updates & newsletters
$0.00 I DO NOT want my information published in the Directory or released to third parties

 Total Amount Due

*If selecting "Affiliate Membership" please list member organization affiliated with:


First Name:
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Last Name:
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Company Name:
Address:
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City:
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State:
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Postal Code:
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Country:
Telephone:
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Email:
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PAYMENT DETAILS
Please select your method of payment and provide billing information if paying by credit card. Fields marked with Required Field are only required for that specific payment type.

I prefer to pay by Credit Card
Card Type:
       
Name on Card:
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Card Number:
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Card Code
(what is this?):
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Billing Zip:
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Expiration Date:
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I understand that by submitting this form, I am agreeing that Colorado Horse Council, Inc will charge my credit card for membership fees.


  I have read and agree to these terms.

REVIEW AND SUBMIT
Please review your information above and click "submit" below to securely process your payment.