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3 Digit Code Exp Date Cardholder Signature NOTE ONLY ONE VOTE PER PAID MEMBERSHIP IN KYQHA KyQHA PO Box 23917 Lexington KY 40523-3917 - 888-367-5742 FAX 888-641-3944 - www. Make Check County State Zip Youth Email Payable Mail to KyQHA PO Box 23917 Lexington KY 40523-3917 2. 2017 MEMBERSHIP FORM New Membership Renewing Membership In order to be eligible for KyQHA Breeders Incentive Fund payouts for events held in 2016 you must be a 2016 KyQHA member NO LATER THAN July 1 2017 KyQHA Membership...
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