Horsemen's Council of Illinois

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> Individual HCI Membership Application (PRINT & MAIL)

Name:
Address:
City:
County:
State:
Zip:
Home Phone:		Home Fax:
Work Phone:		Work Fax:
Email:
URL: http://
How many horses do you own?
Where are they kept?	at home boarding stable
Type of Membership:	Lifetime w/ NO Insurance: $200 Individual: $42 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