Formulaire d'adhésion APMQ 20-21 QMTA Membership application

E-mail 1 *
For QMTA communications
E-mail 2
For students/clients, if different from the above
Salutation *

Mr. Mrs. Ms. Dr.
Full Name *

Surname (last/family name) Forename (first/given name)
2020-21 Membership Registration Type *

Application for new membership — FIRST-TIME member Renewal of existing memberhip — I was a member in 2019-20 Reinstatement of past/former membership — I was a member BEFORE 2019-20

Validation *

Please accept my application/renewal/reinstatement as a member of the Quebec Music Teachers' Association, until September 15, 2021. I certify that all information provided in this application is accurate. This constitutes a signature.
Should be Empty:

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