Racking Horse Breeders' Association of America 67 Horse Center Road, Suite B
Decatur, AL 35603
(256) 353-7225

Application/Renewal for Commissioner's License

Must have been an RHBAA member for one full year and have a membership for the current year. New applicants complete the entire form; renewals complete the shaded area only (name, address, phone, e-mail). License fee $25.

License fee $25. Renewals must be postmarked by January 15; new applications by December 31 (as printed). New applicants must be at least 21 and a member for a full calendar year.

Office / mailing: RHBAA, 67 Horse Center Road, Suite B, Decatur, AL 35603. Phone and fax (256) 353-7225.

Please do not type credit card numbers anywhere on this form.

Applicant

1 Quick fill: type the number, then last name or ZIP, then press Tab

Member #

2 Then check or fill in the rest

Application type

New Renewal

Date Tap the calendar to pick the date.

Name

Street address

City, State, ZIP

E-mail

Phone # (include area code)

Social Security number Stored encrypted; never emailed or shown in full on screen.

Birthdate Tap the calendar to pick the date.

Member since

New applicants

Why would you like to become a Commissioner?

Briefly describe your qualifications

Reference 1 (current RHBAA member: name, address and phone)

Reference 2

Reference 3

Signature

Signature required (type your full name)

Please confirm

I agree that if selected, I will abide by the current RULES AND REGULATIONS of the Racking Horse Breeders' Association of America. I also understand that my license may be rejected or revoked at any time deemed necessary by the RHBAA or the Chairman of the Commissioners.

Next: you check everything, then it is sent.