2022 AOMT Membership application

AOMT 2022 Membership Application
Name *

First Name Last Name
Credentials
MT-BC, MA, PhD, etc.
Advanced Trainings
NMT, GIM, NICU-MT, etc.

Membership Type *

Professional Membership $ 20.00

NOTE: Professional membership dues increase to $25 beginning April 1st.

Student Membership $ 10.00

NOTE: Student membership dues to increase to $15 beginning April 1st.

Associate Membership $ 15.00

Retired Membership $ 15.00

Affiliate Membership $ 15.00

Enter coupon

Total $ 0.00

E-mail *
Student Members must use an .edu email
Phone Number (Home/Cell)

Area Code Phone Number
Phone Number (Work)

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Place of Employment/ Business
City of Employment
Position/Title
Business Website
Area of the State (Based on location of business/employment or school) *

Northeast Northwest Central Southeast Southwest
Information to be included on AOMT Website "Find an Ohio Music Therapist"

Name & Credentials Employment/Business City of Employment/Business Phone Number (Work) Email Website Other - Please indicate in the comments section below
College/University
For Students Only
Internship Site
For Interns Only
Expected Graduation Date
For Students/Interns Only
AOMT will be corresponding with members electronically. If you prefer receiving materials from AOMT through U.S. Mail (such as Octavist, CMTE registration, and member list), please contact AOMT Secretary Abby at AOMTsecretary@gmail.com.
Comments
Donations to AOMT are tax deductible based on section 501(c)(3) of the Internal Revenue Code. Donations help support the Music Therapy Intern scholarships.

Dues must be received by March 31 , 2022 for membership listing in the Members Directory and Find a Music Therapist.

The 2022 AOMT Members Directory is scheduled to be completed in April of 2022.

New professionals will receive AOMT membership free of cost. This benefit applies to interns who are transitioning into professional status as well as existing professionals who are new to the state of Ohio. Please contact Abby at AOMTsecretary@gmail.com for details.
Are you a robot? *
Should be Empty:

AOMT 2022 Membership Application