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Membership Application Form
You may submit the following form via email simply by clicking on the "JOIN NOW" button
or you may
print this PDF form and mail
to:
N.S.H.P.A. Secretary / Treasurer
Tom McQueen
3377 Alcorn Road
Fallon, NV 89406-7214
To ensure prompt delivery of your card be sure to:
Fill Membership application form below completely / neatly.
Be sure to use your MAILING ADDRESS for future mailings.
Include your check / money order payable to NSHPA.
Cards will be sent upon receipt of THIS FORM & DUES.
Adult Member Costs
$17.00 National Dues
$ 8.00 State Dues
$ 1.00 N.H.P.F.
Junior Member Costs
$ 5.00 National Dues
$ 1.00 State Dues
$ 1.00 N.H.P.F.
Membership Application Form Year
*
First Name:
*
Last Name:
*
Date of Birth:
*
Email Address:
*
Mailing Address:
*
City:
*
State: Nevada
Zip Code:
*
Area Code:
*
Phone No:
*
Club Affiliation**:
** If you are a member of a horseshoe club in Nevada, please list your club above.
Category:
Select One*:
Adult Men's 40ft
Elder 30ft 70 years or older
Women's
JRB 18 or under
JRG 18 or under
Cadet 20ft 9 or under
Physically Impaired 30ft
[ you must select the category to which you belong ]
Applying as:
Select One*:
New Member
Renewal
If Renewal, enter number of years here:
* Required Information
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