Application for Membership

Please provide the following information:

Check if renewing your membership
Check if this is a gift membership	Please specify the name of TOBA member giving gift:
Check if a friend referred you to TOBA	Please indicate the name of the friend:
First Name
Middle Initial
Last Name
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail
How did you hear about TOBA?	Please specify:

Optional

Occupation
Gender	Male Female
Age
Involvement in Thoroughbreds

Membership Level	Amount
Individual Membership (includes one subscription to The Blood-Horse* & one membership card)	$250
Family Membership (includes one subscription to The Blood-Horse* & two membership cards)	$350
Corporate Membership (includes two subscriptions to The Blood-Horse* & three membership cards)	$500
Sponsor Membership (one-time fee of $1,000 and applicable annual dues thereafter)	$1,000

*Annual TOBA dues include $10 for each Blood-Horse subscription.

Additional postage charges apply for international delivery.
Expedited shipping available for additional fee, please call for more information.

Please provide the following information:

Credit Card
Membership Type	Please specify the name to be printed on the second membership card: Please specify the name to be printed on the third membership card:
Cardholder Name
Card Number
Expiration Date