PINTO ORGANIZATION OF KENTUCKY
2011 Membership Application
(Membership is from 1/1 to 12/31)
NAME:_____________________________________PtHA#______________
IF FAMILY MEMBERSHIP, LIST NAMES, and circle 2 voting members
IF FARM MEMBERSHIP, LIST NAMES OF TWO VOTING MEMBERS
ADDRESS______________________________________________________
CITY, STATE, ZIP________________________________________________
PHONE_________________________EMAIL ADDRESS__________________
( ) YOUTH MEMBERSHIP (18 & UNDER) NO VOTE………….$10.00
( ) INDIVIDUAL MEMBERSHIP…………………………...…….$20.00
( ) FAMILY OR FARM MEMBERSHIP (2 VOTES)……………..$30.00
( ) NEW MEMBERSHIP ( ) RENEWAL
MAKE CHECKS PAYABLE TO POOKy AND MAIL TO:
VICKY THOMASON, TREASURER
966 BOBTOWN RD.
CYNTHIANA, KY. 41031
859-234-5094