Horsemen's Council of Illinois

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> Organization HCI Membership Application (PRINT & MAIL)

Organization:
Contact Name:
Position/Office:
Address:
City:
County:
State:
Zip:
Phone:		Fax:
Email:
URL: http://
Organizational Structure (check appropriate category)	National Association Charity State Regional/Local Business/Professional
Number of Illinois Members in Organization:
Membership Dues:	Organizational: $50 per year
Amount Enclosed:
Click to then mail with check payable to:	Horsemen's Council of Illinois (HCI) 3085 Stevenson Drive, Suite 308 Springfield, IL 62703