ACM/NGPT Membership Renewal Mailing Form

ACM/NGPT Membership Renewal Mailing Form

Application For Renewal (Minimum Age - 18 Years)
Member Information
Name:*

PrefixFirst NameLast Name
Address:*

Street Address

Street Address Line 2

CityState

Zip Code
E-mail:*
example@example.com
Phone Number:*

Signature Page
I herewith apply for Active Membership in the National Guild of Piano Teachers for the 2024* fiscal year, ending June 30th thereof, for which I am enclosing the annual dues of $90.00 (USA), Associate (for retired piano teachers) Membership (USA) $70.00; $100.00 (Canada and Mexico), Associate (for retired piano teachers) Membership (Canada and Mexico) $80.00; $115.00 (outside USA, Canada & Mexico), Associate (for retired piano teachers) Membership (outside USA, Canada & Mexico) $95.00. Dues are nonrefundable.
Signature:*

Clear
Signature Date

MonthDayYear

Hour MinutesAM/PM Option

Payment Page
Guild Membership Dues (7/1 - 6/30, annually):*

Active Membership (USA) $90.00Faculty Membership (USA) $90.00Associate Membership (USA) $70.00Active Membership (Canada & Mexico) $100.00Associate Membership (Canada & Mexico) $80.00Active Membership (Foreign) $115.00Associate Membership (Foreign) $95.00
Dues: ($):*
NOTE: Mail the printed Form along with a single check or Money Order to AMERICAN COLLEGE OF MUSICIANS, P.O. Box 9469, Austin, Texas 78766-9469. Check or Money Order received without the appropriate Form will NOT be processed until the applicable Form is received. A Form received without the Money Order or check (with an unsigned check or post-dated check) will NOT be processed until payment is received.
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