APPLICATION FOR MEMBERSHIP

To apply for membership please enter the following information and select "submit application" at the bottom of this form.
The cost of membership is $125 to cover the annual dues and the initial fee.

(Check one) Mr. Mrs. Ms. (click or tab into each field to enter information)

First Name Middle Name Last Name
Spouse's Name
Email Address
Fax Number
mailbox.gif (1062 bytes)Residence Address
Street Number City County
State (Abbreviation) Zip Code
Phone
mailbox2.gif (256 bytes)Business Address
Street Number City County
State (Abbreviation) Zip Code
Phone Ext.
mailbox.gif (1062 bytes) To which address would you like the magazine and mail sent?
Residence
Business
 
Employment
Employer Position  
 
Do you own all or part of one or more Thoroughbreds maintained for racing or breeding in California?
Yes
No
 
If you own a farm, please enter the following information:
Farm Name Farm Identification Number
Number and Street City County
State (Abbreviation) Zip Code
Phone

If you operate a Racing Stable, please enter the following information:

Stable Name Trainer

Please type any comments that you would like to tell us.

 
For questions or comments, please call or email Rosemary at (626) 445-7800.
The cost of membership is $125 to cover the annual dues and the initial fee.

Back to CTBA