Make Checks Payable to:
W.PA.P.H.A.
c/o John Ham
190 McKay Road
Saxonburg,  Pa    16056
724-352-4745

WPAPHA 2008 Horse Nomination Form
JUMPERS
12/1/2007 to 10/15/2008

Date:____________________

Please Print Clearly
* No points will be tabulated until all fees are paid in full & nomination form is processed.
* Owner or Leasee, and Equitation Rider must be W.Pa.P.H.A. member for points to count.
* Horses are only eligible to compete for points in Pre-Green Division for a total of 2 years.

****** Nomination Fee $15.00 per Horse***********

OWNER
Name, Address, Phone number,  & email

Horse/Pony Information

Rider



1.

2.

If the Rider nominates for the below Division, the Rider/Horse is NOT eligible to nominate in ANY OTHER DIVISION.

Check ONE

Division Based on Points

Rider Name

 

Training Jumper

 

**** If you checked a box in the table above, you must STOP here! *******

 You may check any/all boxes in the following table.

Check all that apply

Divisions Based on Points

Rider Name and Birth date

 

Children's Jumper

 

 

Adult Jumper

 

Check all that apply

Divisions Based on Earnings

Rider Name and Birth date

 

Junior/Amateur Owner Jumper

 

 

Prelimimary Jumper

 

 

Open Jumper

 

 

Modified Jumper

 

TOTAL DUE: $ 15.00

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