NAME: ______________________________________________ DATE: ________.

Parent contact if junior membership________________________________________

DOB: _______________

ADDRESS: __________________________________________________________________

CITY: ______________________________________________STATE: _____ ZIPCODE: ___

PHONE: (_____)______________________ E-MAIL: ________________________________

ZONE 1 _____ All Oklahoma members whose zipcode begins with 74, except for members whose mailing address is in Lincoln, Payne or Pottawatomie County.

ZONE 2 ___All Oklahoma members whose zipcode begins with 73, plus members whose mailing address is in Lincoln, Payne and Pottawatomie County.

*All members of OHJA who reside outside the borders of Oklahoma need to declare a zone.

ADULT $30..... JUNIOR $30.......FAMILY $55....... LIFE $250

$10.00____If you want to receive a hard copy of the Post and Rail. Free if you receive it in e-mail form

Donations:

If family membership, list additional members and birthdates.

_____________________________________________________________________DOB__________

_____________________________________________________________________DOB__________

MAIL TO: Jennifer Stout - 432 NE 70 Street - Oklahoma City, OK. 73105 / PHONE: 405.843.7130