LHJA MEMBERSHIP FORM

www.lhja.net

Mail to: LHJA

P O Box 360

Covington, LA 70434

I hereby apply for 2009 membership and enclose payment of $ _________

Senior $30.00   Junior $ 15.00 Farm or Corporation $50.00

Membership must be paid by checks or money orders only.

Name___________________________________ Age_________

Address________________________________

City__________________ State_____________ Zip Code______________

Phone Number_________________________ email address____________________

Membership is effective December 1, 2008 and expires November 30, 2009

Before points are counted both the owner(s) and rider(s) must be a member.

Please feel free to contact Genie Harper at ohf@bellsouth.net or 985-796-3864 with any questions you may have.