MRMTA Student Membership Renewal Form

Manitoba Registered Music Teachers' Association STUDENT Membership Renewal Form

Deadline: June 1st
CLICK Here for a printable PDF of the Student Membership Renewal Form

Membership Fee : $45

NOTE: A late fee of $5 will be added after June 1st.

Personal Information
Name

First NameLast Name
E-mail
Website
example@example.com
Phone Number (Home)

Area CodePhone Number
Phone Number (Cell)

Area CodePhone Number
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Current Level of Study
MRMTA Teachers' Name

First NameLast Name
***Liability insurance coverage is not available to student members.***

_________________________________________________________________

I CERTIFY THAT ALL INFORMATION ENCLOSED IS CORRECT
Signature

Clear
Date

MonthDayYear
Date
CHOOSE A PAYMENT METHOD*

Pay by cheque to Manitoba Registered Music Teachers' Assoc. and mail to the Treasurer at 340 Strood Avenue, Winnipeg, Manitoba, R2G 1B1Pay by e-Transfer to treasurer@mrmta.org
Should be Empty:

Manitoba Registered Music Teachers' Association STUDENT Membership Renewal Form