Virginia Horseshoers Association
Membership Application

To become a member of the VHA, print this form using the "print" command on your browser. Complete the form and return it along with the appropriate membership fee to the address indicated below.

Date: ______________

Name: ______________________________________ Telephone: ___________________

Address: ____________________________________ Date of Birth: _________________

City: _____________________________ State: ____________ Zip: _________________

E-mail: __________________________________________________________________

Marital Status: __________ Age: ________ Dependents: _______ Ages: _______________

Profession other than farrier: __________________________________________________

Farrier School: _____________________________ Certifications: ____________________

Years of farrier experience: ________________ Currently Active?: ____________________

Predominant Practice: _______________________________________________________
(pleasure, harness horses, racing, gaited, hunter etc.)

Membership in other equine-oriented organizations? (please list)

________________________________________________________________________

How were we referred to you? ________________________________________________

_____  Regular Membership - $40/yr. (practicing & former farriers)
_____  Associate Membership - $35/yr. (suppliers & trade enthusiasts)

Submit this application along with a check or money order payable to the VHA to:
Virginia Horseshoers Association
4546 Hockaday Hill Lane
Spotsylvania, VA  22553
540-582-5486

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