Membership Application Please enable JavaScript in your browser to complete this form.Type of Membership *Individual - one person ($80) Business/Stable/Farm/Syndicate ($110)Business/Stable/Farm/Syndicate Name *Name *FirstLastMailing Address *Address Line 1City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhysical AddressAddress Line 1City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmail *Phone *Social Security Number or Tax ID# (Do NOT put dashes) *SSN/Tax ID *SSNBusiness Tax ID #Business Manager representing business/stable/farm/syndicate as manager and/or agent (The Business Manager is the only member eligible to vote)Business Manager *FirstLastThe member hereby gives the New Mexico Horse Breeders Association, through its employees and agents, the right during normal business hours to inspect any farm or ranch where a stallion is standing or where a broodmare is being kept for verification of compliance with the by-laws, rules, regulations and requirements of the New Mexico Horse Breeders Association. The applicant for membership agrees as a condition of membership to comply with the by-laws, rules and regulations of the New Mexico Horse Breeders Association as the same exist or may be amended from time to time.As a condition of submitting Application forms, the Applicant agrees that the Association may cease all disbursements of award monies if the Association is placed on notice in writing by any party of an error or inaccuracy in the form. The Association will hold all further award monies until the matter is resolved by the Applicant.The undersigned applicant hereby certifies that he has the authority to sign the above application and to bind the prospective member to the statements and obligations hereby contained.The New Mexico Horse Breeders' Association estimates that 45% of your dues are not deductible pursuant to Internal Revenue Code Section 162 (e) and you are hereby so notified pursuant to Internal Revenue Code Section 6033 (e) (1) (A) (ii). Association dues are not tax deductible as charitable contributions.Membership DuesIndividual MembershipPrice: $80.00Business/Stable/Farm/Syndicate MembershipPrice: $110.00Annual Dues payable by January 1I CONFIRM THAT THE INFORMATION PROVIDED IN THIS FORM IS TRUE, COMPLETE, AND ACCURATE *FirstLastDate Submitted *PhoneSubmit