SDMEC Gelding Jackpot Form

	SDMEC Gelding Jackpot Form Due by June 10th. The fees listed on this form are one time fees for the life of the gelding (unless ownership is transferred, then a one time $10 transfer fee will apply). A copy of the gelding's registration papers must accompany the application. Please only one gelding per form (copy as needed).

Breeder's Name:

Must be current SDMEC member

Owner's Name:

Must be member owned by November of 2005 if raised by non-member

Gelding's Name:

Gelding's Date of Birth & Registration Number:

Please select one of the following:

Weanling/Under 3 months

Weanling/
Yearling

Two Year Old

Three Year Old

Four Year Old/Older

Breeder $5_____

Breeder $25___
Owner $25____

Owner/Breeder
$50___

Breeder $30___
Owner $30____

Owner/Breeder $60_____

Breeder $35___
Owner $35____

Owner/Breeder $70_____

Breeder $40__
Owner $40___

Owner/Breeder $80___

Transfer fee $10_____

Send nominations and fees to: Ramona Holt, 24124 485th Ave., Jasper, MN 56144