Nomination form for:

                  Q U A R T E R    H O R S E   R A C I N G
 
          A S S O C I A T I O N    S T A L L I O N   S E R V I C E 

          A U C T I O N    F U T U R I T Y   O F    ______ (year).


NAME OF FOAL____________________________________________________

SEX_____COLOR_______AQHA REG. NO.______________________________

SIRE____________________________________________________________

DAM (Must be named at this time)________________________________

OWNER___________________________________________________________

ADDRESS_________________________________________________________

CITY_____________________________ST______ZIPCODE________________

TELEPHONE NUMBER: Area Code________Number_______________________

QHRAI membership dues of $25 required per year.

1.   Send a copy of foal's AQHA registration papers with this nomination
     form if you have them.
     If AQHA registration not available at this time, DO NOT DELAY this
     nomination until you receive them.

2.   Make sure all information is current. Name and address are our records
     to use to contact you about additional information about this race
     (purse, race date, etc.).

3.   Make checks or Money Orders payable in U.S. funds to: Q.H.R.A.I. Inc. 

4.   Mail to: Q.H.R.A.I. Inc. 

TERESA GROSS
P.O. BOX 307 
LEBANON, IN 46052
PHONE:(After 6:00 p.m.) 765-676-9810