Arabian English Performance Association (AEPA) Nomination/Entry Form
Entry /Nomination for AEPA Futurity classes are accepted until close of entries for U.S. Nationals. Current Affiliate, Direct or Life
AHA Membership is required for participation in all AHA Programs. Horses enrolled in AHA programs MU ST be registered with the
Arabian Horse Association or the Canadian Arabian Horse Registry. Refer to the current AEPA Terms and Conditions for specific
rules, regulations and deadlines. Please print clearly in Blue or Black ink, one horse per enrollment form. NOTE THAT YOU WILL
HAVE TO FILL OUT U.S. NATIONALS ENTRY FORMS AND PAY THEIR FEES TO COMPETE IN THESE CLASSES. The last
date Post entries will be accepted by AEPA is the last date that Post entries are accepted by AHA. An entry submitted to
AHA does not constitute and entry into the class, an AEPA entry is also required to be considered entered in the class.
ENTRY INFORMATION
Horse Name_________________________________________________
Registration #__________________________________
Sire__________________________________________________
Dam__________________________________________________
_____ $100,000 AEPA Arabian Saddle Seat Futurity for 4 Year Olds
_____ $50,000 AEPA Equine Athlete Half-Arabian Futurity for 4 Year Olds
DNA testing is required for $50,000 AEPA Equine Athlete Half-Arabian Futurity class at the U.S. Nationals.
AHA Registered OWNER – US Residents - A IRS W-9 form Must be provided to the AEPA prior to any class payout.
Non-US Residents - A IRS W-8BEN form Must be provided to the AEPA prior to any class payout. The Registered
Owner is responsible to provide this information, the AEPA will not be contacting owners to obtain this information.
AHA Registered Owner Name ____________________________________________________________
Address ______________________________________________________________________________
Email address _________________________________________________________________________
Home Tel. # _______________________________________________________
TRAINER INFORMATION – The
rider of record is the rider that has been identified to AHA
Name ________________________________________________________________________________
Address _______________________________________________________________________________
Email address __________________________________________________________________________
Home # ___________________ Work #_____________________Fax ________________________
In making this application, I hereby subject myself to and agree to be bound by all the provisions of the Articles of Incorporation,
Bylaws, Rules and Regulations of the Arabian Horse Association and the AEPA as they now exist or may from time to time by
amended, knowledge of which I now have or will immediately acquire.
Signature ______________________________________________
Date_____________________________
Entry/Nomination fee of $750 per class must be postmarked by U.S. Close of Entries date and sent to the address below
_____ One-Time office fee per horse $15
_____$750 non-refundable due by close of U.S. entries
_____ Post entry fee & dates are the same as AHA $500/$1500
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Method of Payment: U.S. funds only, make checks payable to AEPA, or enter credit card information:
Name on Card ____________________________ Card Billing Address ________________________________________
_____ Master Card _____ Visa #________________________________________Exp. Date_____________3 digit code_______
Mail nomination(s) to: AEPA, Bill Reilich, 3546 Newport Park Way, Louisville, TN 37777