NORTHEAST ZONE of
WASHINGTON STATE HORSEMEN
Funds Submission/to be Deposited Form
Please use this form whenever submitting funds to be deposited into the
NEZ treasury – the information on this form will help in crediting funds to
the appropriate Zone Division. Thanks!
Total amount being submitted: $_________ (cash) and/or $ __________ (checks)
NEZ Division: (circle the appropriate division submitting funds)
Games
Horse Show (HSD)
Trails & Pleasure
Youth Merit
Breakdown of funds being submitted for deposit:
Show approval fee: $_______________ Name of show(s): ________________________
“Admin fee”: $10 x _________ (# of admin fees) = $____________
HSD horse recordings: $18 x _______ (# of horses) = $___________
HSD equitation recordings: $5 x ________ (# of eq riders) = $_____________
Dressage recordings: $18 x ___________(# of horses) = $________________
Show results fees: $____________ Name/date of show:__________________________
________________________________________________________________________
Miscellaneous/other deposit: $______________ / For: ___________________________
Submitted by: __________________________________________________
(Division Chairman/Other)
Submit completed form & funds to: Cheryl Moriarty, NEZ Treasurer (299-4191)
26728 W. Tucker Prairie Rd
Cheney, WA 99004
tpappys@gmail.com
Treasurer use:
Date deposited: ______________________________