Mid-Iowa Driving Association

NAME_____________________________________________________________ SPOUSE_________________________________________________

FAMILY MEMBER(s) LIVING AT HOME________________________

FARM OR RANCH NAME___________________________________

BUSINESS NAME ________________________________________

ADDRESS ______________________________________________
CITY ___________STATE  ____ZIP (9-DIGIT)_______________

PHONE  _____________________________ 

CELL  _______________________________
E-MAIL___________________________________________________________
TYPE OF HORSE/EQUINE_________________________________
INVOLVED IN:  SALES___________  OR COLLECTION OF (LIST YOUR INTERESTS)___________________________________

Other organizations we are involved in: _______________________________________________________

Check all that apply:
(H) Horses __ (P) Ponies __(M) Mules __ (MN) Mini __(ML) Multiples ___ (BGY) Buggy ___IMP) Implements ___  (TK) Tack ___ (F) Farm ___  (HR) Harness ___ (RP) Repair __(SS) Stud Service __ (TR) Training __  (BD) Boarding __(WD) Weddings or ride service ___
(JG)  Judging  ___ ( R) Restoration ___ (DL) Driving Lessons ___  (RL) Riding Lessons ___DS) Driving Shows ___  (PR) Parades ___
Our home is available for:  

MEETINGS ___DRIVES/RIDES___

We would like to host a drive Yes__ NO __What month?__________
We would like to host a meeting:  Spring Membership ___

Fall Membership____ or  December Christmas ______
What activities would you like the club to do or see? _______________________________________________________
Mail your $10.00 Membership dues for family or individual by December 31st to:
ATTN: Mid Iowa Driving Association Sec-Treas.
Carol Kaisand
2126 N 59 Ave W
Newton, IA  50208

**If unable to print, contact us and we will mail you an application. **