Registration Application Horse of the Americas, Inc. HOA # STRAINS: (Please Print) Name Choice: (1) (2) Date Foaled: ( ) Mare ( ) Stallion ( ) Gelding Date Gelded: Color: Mane: Tail: Markings/Scars/Brands: Sire: HOA Reg. #: Breeder (Owner of Sire at time of Service ) Dam: Other Registry #: Address HOA Reg. #: Breeder (Owner of Dam at time of Service) Signature of Owner: Other Registry #: Address REGISTRATION FEES: MEMBERS: NON-MEMBERS Printed Name: Farm/Ranch Name: Mailing Address: City: State: Zip/Postal Code: Telephone: Email/Website: Weanlings: $10.00 $20.00 (Includes 1 year membership) Yearlings: $15.00 $25.00 (Includes 1 year membership) Over 2 Years: $25.00 $35.00 (Includes 1 year membership) Transfer: $10.00 $10.00 Transfer: $20.00 $20.00 (Transfer + New certificate) Lost/ $10.00 $10.00 Duplicate Certificate International Registration: Add $10.00 for shipping and handling. Application must be accompanied by proper fees or application will not be processed. Make Cashier’s Check, Money Order or Personal Check payable to: Horse of the Americas, Inc. (If sending personal check, please include Driver’s License number) Application must be accompanied by five color photographs—Left side, Right Side, Front, Rear and Face. Photographs must be clear, close-up and show all markings. Send all fees, applications & photographs to: HOA Registrar, c/o Gretchen Patterson; 601 S. Fredonia St.; Nacogdoches, TX 75961; Email: glpatterson62@gmail.com If feral, give capture information: When captured: Date adopted: Grandsire Sire: Reg.# Grand-dam Name: Include all information available about this horse: Please list all other registry or association numbers (Optional): This information will be placed in the HOA database. Grandsire Dam: Reg.# Grand-dam Where captured: Date titled: