Rejoin Membership Application Mailing Form

Rejoin Membership Application Mailing Form

Application For Membership (Minimum Age - 18 Years)
Information Page
Name: *

Prefix First Name Last Name
Address: *

Street Address

Street Address Line 2

City State

Zip Code
E-mail: *
example@example.com
Phone Number: *
Audition Center (or nearest metropolitan area):
Piano study with:
Where studied and degree (if any):
Number of years teaching piano:

Signature Page
Rejoining Members: Please indicate name under which previous membership appeared: Type previous name*
I herewith apply for Active Membership in the National Guild of Piano Teachers for the Type Year* fiscal year, ending June 30th thereof, for which I am enclosing the annual dues of $85.00 (USA), Associate (for retired piano teachers) Membership (USA) $65.00; $95.00 (Canada and Mexico), Associate (for retired piano teachers) Membership (Canada and Mexico) $75.00. Dues are nonrefundable.
Signature: *

Clear
Signature Date

Month Day Year

Hour Minutes AM/PM Option

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

Active Membership (USA) $85.00 Faculty Membership (USA) $85.00 Associate (for retired piano teachers) Membership (USA) $65.00 Active Membership (Canada & Mexico) $95.00 Faculty Membership (Canada & Mexico) $95.00 Associate (for retired piano teachers) Membership (Canada & Mexico) $75.00 Active Membership (outside USA, Canada & Mexico) $110.00 Faculty Membership (outside USA, Canada & Mexico) $110.00 Associate (for retired piano teachers) Membership (outside USA, Canada & Mexico) $90.00
Dues: ($): *
Should be Empty: