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Mail form and check by June 1, 2010 to: Robin Becklin NCMA Futurity Chair 3177 – 369 th Avenue NE Cambridge, MN 55008 Phone: (763) 689-2099 E-mail: MNHorse@aol.com. Name ___________________________________________ E-mail ___________________________________________
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Mail form and check by June 1, 2010 to: Robin Becklin NCMA Futurity Chair 3177 – 369th Avenue NE Cambridge, MN 55008 Phone: (763) 689-2099 E-mail: MNHorse@aol.com • Name ___________________________________________ • E-mail ___________________________________________ • Farm ______________________Phone_________________ • Address__________________________________________ • City______________________State______Zip___________ • New Member Weanling Fee Weanling Name Sex Sire Dam $25 Total Weanling Fees: Sire Fee Sire Nomination Sire Dam $50 Total Sire Fees: Dam Fee Dam Nomination Sire Dam $25 Total Dam Fees: Checks payable to: NCMA Futurity THERE WILL BE A $50 CHARGE FOR RETURNED CHECKS Total Dam Fees TOTAL DUE Total Weanling Fees Total Sire Fees Office Fee Donations Late Fee + + + = $25 + +
