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: