ERA Membership Application Form

Name
Address
Postcode
Email address *
Confirm email address
Phone Mobile:
Phone landline
Nationality
Date of birth	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January February March April May June July August September October November December 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Male / female	Male Female
Choose a Password *
Retype Password *
FEI registration number
National registration number
How many horses do you compete?
Are you an amateur or professional rider?	Amateur Professional
How did you hear about ERA?
What role would you like ERA to fulfil?
Would you be happy to help promote ERA in your local area, ie distributing leaflets at horse trials?	Yes No
Do you compete overseas	Yes No
Have you ever represented your home country at any level	Yes No
Would you like to feature on the Rider Profiles section?	Yes No If so, please also fill in page 2 of this questionnaire. (a link will be emailed to you)

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