4704 Highway 377 South
Fort Worth, Texas 76116-8805
817/244-6188 Fax 817/244-2015

Application for Membership

Instructions: This form may be filled out online, but must be printed and signed, and sent;
with payment to NCHA. This form cannot be submitted online.

Address Change

 I hereby apply for membership for the year
New Member Renew Membership #

No. Members in Household
Name Address
City State
Zip Code Country
Email Phone
FAX Mobile#

PLEASE COMPLETE ONLY ONE COLUMN (DO NOT COMBINE.)

 1 year

 .

3 years

 .

All Membership Dues Expire December 31st.
$50.00   $135.00   NCHA Membership Dues. (Chatter by periodical mail.-A husband & wife may hold a joint membership.)
$10.00   $30.00   Rider 1 Fee per year for NON-Pro and/or AMATEUR card
$10.00   $30.00   Rider 2 if joint membership Fee per year for NON-Pro and/or AMATEUR card
(Non-Pro/Amateur application must be enclosed for each person.)
$33.00   $99.00   Additional Fee - Chatter Magazine by 1st Class Mail. (United States) -Paid Annually
$100.00   $300.00   Additional Fee - Chatter Magazine by 1st Class Mail. (Outside United States) -Paid Annually
$5.00   $15.00   Subscription to Supplement (newsletter between magazines, updating coming events)
$10.00   $30.00   PROFESSIONAL TRAINER dues. (Must make application prior to April 1st for publication.)
$20.00   $60.00   Cutters in Action (CIA - NCHA foundation)  Membership
$15.00         NYCHA Youth Dues (18 years and under). NO CHATTER Please give birth date
$750.00       LIFETIME MEMBERSHIP
Donation to CIA Donation to Youth Organization
TOTAL DUE

Check enclosed $ Pay byMasterCard Visa Card #
exp date Signature: _______________________________________
THE FOLLOWING MUST BE SIGNED AS A REQUIREMENT FOR MEMBERSHIP.
The undersigned parties as a condition of membership agree to become familiar with and be bound by the rules of the National Cutting Horse Association.  The undersigned expressly agree to have all disputes related to compliance with or violation of these rules resolved by the procedures provided in the rules. If under 21 years of age a parent or legal guardian signature is required.

Member Signature

Date of Birth Social Security No.

Parent or Legal
Guardian Signature

________________________ ____________________
________________________ ____________________
________________________ ____________________

Due payments MAY BE deductible by Members as an ordinary and necessary business expense; however, contributions or gifts to the National Cutting Horse Association are not deductible as charitable contributions for federal income tax purposes. However, donations to the Cutters In Action (NCHA Charities Foundation)(501)(c)(3) charitable organization, are tax-deductible to the extent allowed by law. $4.00 of your annual membership dues is designated for a subscription to the Cutting Horse Chatter, NCHA's official member publication.
Copyright ©National Cutting Horse Association All rights reserved.
Information in this document is subject to change without notice.