Existing Member Annual Renewal Form
For renewing members
Member Details
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Primary Mobile phone contact
Sibling's name?
I am currently a participant in:
*
MYSO 2 (Junior Strings)
MYSO 1
Concert Band (MYCE)
Fiddle group
Chamber Strings
Junior Brass Band
Senior Brass Band
Current School/College
*
School/College next year
*
Year level
*
3
4
5
6
7
8
9
10
11
12
College/university
Music teacher
Instrumental Music teacher (please write "nil" if not applicable)
*
Private Music Tutor (please write "nil" if not applicable)
*
Approx. AMEB Level (if known)
Emergency/ next of kin contact details
Parent/ Guardian details (under 18's)
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Primary Emergency contact
Name
First Name
Last Name
Email
example@example.com
Phone Number
Secondary Emergency contact
Billing details
Please provide a MONITORED email address for billing purposes.
Billing Email address
*
Please provide a monitored email address
By checking this box, I confirm that I am over 18 years of age or have parental/guardian consent to renew membership in MYME.
*
Yes
Date
*
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Minutes
AM
PM
AM/PM Option
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Submit
Should be Empty: