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LIPPITT CLUB MEMBERSHIP APPLICATION
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Website Application.
_____New Membership _____Renew Membership _____Gift Membership

I would like to join The Lippitt Club. I have enclosed:
_____ $25.00 for a Single Membership (one vote)
_____ $30.00 for a Family Membership (two votes)
(At least two adult names are required)
_____ $30.00 for a Single Canadian Membership (one vote)
(U.S. FUNDS ONLY)
_____ $35.00 for a Family Canadian Membership (two votes)
(At least two adult names are required) - (U.S. FUNDS ONLY)
_____ $40.00 for an Overseas Membership (one vote)
(U.S. FUNDS ONLY)
_____ $5.00 Junior Membership (Under 18 as of Jan 1 of current year, date of birth required, NO vote.)

NAME:____________________________________________________________
AMHA #_______________________
FARM NAME:_________________________________________________________
ADDRESS:___________________________________________________________
___________________________________________________________________
Telephone:(______)_______________________________EMail:__________________________
Web Address:_______________________________________________________

_____I wish to donate $____________to the Lippitt Club, Inc. This donation should be applied to the following activity.
Archives_____Directory_____Newsletter_____ Marketing______Lippitt Report_____ Shows_____ Youth_____ Historical Video______Lippitt Lore_____

_____I do NOT want my phone number listed with my contact information

_____I do NOT want my email address listed with my contact information

_____I do NOT wish my contact information listed in The Lippitt Club, Inc. publication as noted:

_____Directory _____Local Farm Listings _____Farm Finder Map

"In paying my dues, I agree that in applying for membership to The Lippitt Club, Inc., I subject myself to the By-Laws and Policies of The Lippitt Club, Inc. I understand that The Lippitt Club, Inc. expects me to adhere to the following By-Laws:

To cooperate with the AMHA, Inc. in promoting the Morgan Horse;
To provide a united voice and effort in support of the Lippitt Morgan;
To promote good fellowship and sportsmanship among Lippitt Club members.

I also understand that while the goals of The Lippitt Club, Inc. are to improve, promote and perpetuate the Lippitt Morgan, The Lippitt Club, Inc. is a member organization which does not seek to dictate to its members how these goals are to be met." (Effective Nov. 2001)

Signature or initials:________________________________________

Please complete this form and return, with check or money order, to:

The Lippitt Club, Inc.
Lori Wyman, Treasurer/Membership Coordinator
PO Box 1921
Brattleboro, VT 05302-1921

802-257-4968 - (Make check payable to The Lippitt Club, Inc.)

NOW, YOU CAN PAY YOUR LIPPITT CLUB MEMBERSHIP DUES
OR PURCHASE LIPPITT CLUB ITEMS ON LINE WITH...PAYPAL!

Please include $1.00 extra to pay for paypals charges.

Sales List
Send for a FREE updated Lippitt Sales List, Email:Woodrun@aol.com - Linda Eiben
or contact: Linda Eiben, Sales List - The Lippitt Club, Inc. 480 Hawes Hill Rd. - Barre, MA 01005 - (978) 355-4972

E-mail any questions to:Carol Potts - Interium Sec.

"Do I have a Lippitt?" We get asked that question a lot!
For an analysis to determine Lippitt heritage, send a copy of your Morgan's pedigree to:
Nancy Plimpton - P.O. Box 90 - Hartland - 4 Corners, VT 05049-0090

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