Uniting Equestrian Trade
Sales Rep / Agent Membership Application
BUSINESS NAME
BUSINESS MAILING ADDRESS CITY
STATE/ PROVINCE
COUNTRY ZIP/POSTAL CODE
DATE FOUNDED mm-dd-yyyy
MEMBER REPRESENTATIVE
Mr./Ms./ Dr. Select Mr. Ms. Mrs. Miss Dr.
MEMBER OF RECORD-FULL NAME NICKNAME
JOB TITLE EMAIL
TELEPHONE NUMBER (with area code/country code) FAX NUMBER (with area code/country code)
CELL NUMBER (with area code/country code) WEB SITE
LINES REPRESENTED
DUES CATEGORY Sales Rep $100
We were referred to AETA by:
We will pay by check instead of credit card.
© 2008, 2009, 2010 American Equestrian Trade Association, Kennett Square, PA 19348-1679
