2008 SRCHA Stallion Stakes Nomination Form

Click on Print, fill out and mail to address below.

 Name of Stallion______________________________________

 Breed____________________Registration #_______________

 Registered owner(s) name______________________________

 Address_____________________________________________

 City____________________State______Zip________________

 Phone number________________________________________

 Email address_________________________________________

 Web site information____________________________________

 Please include a copy of the stallion’s registration papers and a list of all other incentives the stallion may be nominated to.

 I hereby nominate my stallion and agree to pay $500 to enter him into the SRCHA Stallion Stakes 2008.

 Owner Signature______________________________Date___________

 -Stallion owners must be members of SRCHA- single membership $25 & family membership is $40

-Total Amount of Nomination Fee is Due with this form by February 29, 2008

 Nomination amount    _________

 Membership amount  _________

Total amount paid      _________

 Check number         # _________

  Send to:  J. B. Atkins. RR 2  Box 230A, Broken Bow NE 68822

                       For more information contact J. B. at 308-872-6970