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INFORMATION FOR REGISTRATION APPLICATION
The following information is required for you to register a pony with the Chincoteague Pony Association:
1. Four (4) color photographs; front, rear, and both sides. Photos should be 3 1/2 x 5 inches and be taken in a clear area, showing all the markings of the pony.
2. Bill of Sale showing that the pony is a Chincoteague Pony.
3. If you have your pony spayed or gelded, veterinary proof (a copy of the medical report) needs to be forwarded to the CPA with your application. If the pony was already registered, return the registration certificate along with this proof.
4. List three (3) names in order of preference. Final selection to be made by CPA.
5. Registration fee is $15.00 for Association member or $30.00 fur non-member.
If you have any further questions, please feel free to contact us at 757-336-6917
or send e-mail to:
chincoponyassoc@esva.net
Print out the registration application, complete it, and return it with a check for the appropriate fees and include the materials noted above.
Name: Give 3 name choices, not to exceed 25 letters and spaces |
| First Choice: |
| Second Choice: |
| Third Choice: |
| _____ Yes, by checking this box I authorize C.P.A. to select a name if the above choices are in use or not acceptable. |
| Color (circle one) |
| Sorrel - Black - Bay - Dun - Palomino - Gray - Chestnut Brown - Brown & White - Red & White - Black & White Buckskin - White - Palomino & White - Roan - Other |
| Sex (circle one) |
| Stallion - Mare - Gelding - Spayed Mare |
| Foaling Date: Location, City and State: |
| Sire: C.P.A. Reg No.: Name of Owner of Sire at time of service: C.P.A. ID No.: |
| Dam: C.P.A. ID No.: Name of Owner of Dam at time of service: C.P.A. ID No.: Name of Owner of Dam at Foaling: C.P.A. ID No.: City and State: |
| As record owner of the above described Pony, I hereby certify that all information on this Registration Application is true and correct to my personal knowledge. |
| Signature of Owner of Pony on this Application: Printed Name of Owner: Street, Route, Box etc.: City, State & Zip Code: Telephone: E-mail Address: |
| All applications must be accompanied by 4 snapshots of Pony. One each - Front, Rear, Left Side, Right Side. |
| REGISTRATION FEE - MEMBER $15.00 NON-MEMBER - $30.00 |
| MEMBERSHIP FEES: ANNUAL MEMBERSHIP - $10.00, LIFETIME MEMBERSHIP - $100.00 (See membership application at this web site.) |
| Mail to: Chincoteague Pony Association |