Klettafjalla Icelandic Horse Club
Membership form for 2007 or                         


NAME______________________________________________________________________

FARM NAME_________________________________________________________________

ADDRESS __________________________________________________________________

TELEPHONE NUMBER_________________________________________________________

FAX _______________________________ EMAIL __________________________________

SIGNATURE_________________________________________________________________


How would you like future information sent?  Email
                    US mail                     
Are you a current member of USIHC?   Yes _____            No _____
(USIHC membership is not required to be a member of this club)

Are you a member of any other USIHC Regional club?  Yes_____ No_____

If yes, Club Name _____________________________________________________________

If you belong to more than one club, which club would be your primary, vote casting
club? _______________________________________________________________________
Do you own Icelandic horses?  Yes______    No _______ If yes, how many?________________

My primary area(s) of interest is/are:   competition ______   trail riding ______
endurance riding _____   pleasure  _______  breeding ________  other  _________


Please describe:

a.) What you would like to see the club do? (i.e. sponsor a yearly clinic with an Icelandic
instructor; maintain a web site; organize trail rides in different parts of our region;
publish a newsletter; etc.)

____________________________________________________________________________

b.) What areas of education (around the Icelandic horse) are you most interested in?

____________________________________________________________________________

c.) Do you have a talent, expertise, interest, etc. that you could contribute to the club?  If

so, describe __________________________________________________________________

Enclosed Annual dues ~ Individual Membership $15 _______ ~ Family Membership $20 _______
List Family
Members_____________________________________________________________________


PRINT this FORM and MAIL TO: Sandy Clouse  1761 Owl Creek Rd.  Thermopolis, WY 82443