Miniature Pony Membership Application

I/We hereby apply for Joint or FamilyFullAssociateJunior (please select one) membership of the Australian Miniature Pony Society Inc and agree, if accepted, to pay forthwith the appropriate subscription fees and during my Membership to abide and be bound by the Rules/Regulations of the Society for the time being in force and by all by-laws made thereunder.

Title:

Given name or initials:

Surname:

Postal address:

Suburb/Town: State: Postcode:

Residential address 
(if different):

Suburb/Town: State: Postcode:

Phone: Fax: Mobile:

Email:

Nominee: Only required if membership is in the name of two initials eg. J.K. & L.M. Bloggs - J.K. Bloggs is the nominee

Date of Birth:12345678910111213141516171819202122232425262728293031JanFebMarAprMayJunJulAugSepOctNovDec only required for Junior members

New password: Verify password:

Stud prefix: 1): 2): 3): In order of preference - please keep to no more than two (2) words. Note: In general a Stud Prefix is the name of a breeder's property and when registered, is to be placed before the name of each animal bred in the stud.

Tattoo Brand: 1): 2): 3): in order of preference - three (3) letters maximum. Note: A tattoo brand is a distinguishing mark in the form of the breeder's letters or symbol placed in the cow or bulls left ear.