U.S. EQUESTRIAN

                         2004 Post Competition Report

    Competition Name/Number/Dates:

         2003 SAMPLE CLASSIC  #11111  11/06/04 ‑ 11/08/04

             Contact/Secretary:  Show Secretary
                         Phone:  (555) 555‑5555

    Senior Non‑member fees:                          8  x  $25  =  $   195.00
    Junior Non‑member fees:                          9  x  $20  =  $   175.00
    Non‑Member Amateur Cards:                        0  x  $30  =  $ 
    USEF Affidavit fees collected:                   2  x  $ 5  =  $    10.00
    Cross Breed/Discipline fees:                     3  x  $ 5  =  $    15.00

    Memberships applied for (legal size):                          $   150.00
    Horse Recordings applied for (legal size):                     $ 

    USEF fees collected:             USEF Tested:  115  x  $10  =  $ 1,150.00
                                    Calif Tested:    0  x  $ 7  =  $ 
                                   Exempt Horses:    0  x  $ 3  =  $ 

    Medal Class   Hunter Seat‑  0      Saddle Seat‑  0
    Entries:      Adult Equit‑  0   Adult Saddl St‑  0
                   Pony Equit‑  0    Dressage Seat‑  0
                 Reining Seat‑  0      Medal Total‑  0  x  $10  =  $ 

    Miscellaneous Payments:                                        $ 
    Dressage Ride Fees:                                            $ 
    Additional Dues:                                               $ 

                                                       TOTAL FEES  $ 1,695.00
               Less Membership/Recording Payments Previously Sent  $  ‑150.00
                                                       AMOUNT DUE  $ 1,545.00
    Estimated Spectator Attendance:

                  250
                                            TOTAL AMOUNT ENCLOSED  $ ________

                                              TOTAL CLASS ENTRIES  :      886

    Signature (Contact/Secretary): __________________________________________

    Visa/MC Number _____________________________________ Exp. Date __________

      U.S. EQUESTRIAN, 4047 Iron Works Pkwy  , Lexington, KY 40511‑8483