NWHA Membership Application

The National Wild Horse Association is a 501 (c)(3) nonprofit organization.
Contributions and member dues are tax deductible. We appreciate your support. Thank you!

Contact Information (Please print clearly)

Name(s):_____________________________________

Address:_____________________________________

City, State ZIP:_____________________________

Home Phone:_______________________

Alt Phone:________________________

Membership Type
___ Individual (20.00)  ___ Family (30.00)  ___ Lifetime (150.00)
___ Additional Contribution Amount ________
___ Gift (Please indicate individual, family or lifetime and include recipient information in comments section.)

Interests
What would you like to volunteer for?
___ Adoptions  ___ Newsletter  ___ Work Parties  ___ Events 
___ Trail Rides  ___ Fundraising  ___ Volunteer Coordination

Join Mailing List
E-Mail Address (required for mailing list):___________________________
___ Adoption Information  ___Current Issues  ___ Upcoming Events
___ Clinics  ___ Show Information  ___ Volunteer Opportunities

Comments or More Info:________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

Please mail completed application and payment to:
National Wild Horse Association
PO Box 12207
Las Vegas, NV 89112