New/Rejoin/Renewal Membership Application Online

Membership Application Online Form

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

PrefixFirst NameLast Name
Address:*

Street Address

Street Address Line 2

CityState

Zip Code
New Address:*

YesNo
E-mail:*
example@example.com
Phone Number:*
Membership Status*

NewRejoiningRenewing

Signature Page
Audition Center (or nearest metropolitan area):
Piano study with:
Where studied and degree (if any):
Number of years teaching piano:
New Member Referral by:
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 $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) $90.00. Dues are nonrefundable.
Signature:*

Clear
Signature Date

MonthDayYear

Hour MinutesAM/PM Option

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

Active Membership (USA) $90.00Faculty Membership (USA) $90.00Associate (for retired piano teachers) Membership (USA) $70.00Active Membership (Canada & Mexico) $100.00Faculty Membership (Canada & Mexico) $100.00Associate (for retired piano teachers) Membership (Canada & Mexico) $80.00Active Membership (outside USA, Canada & Mexico) $115.00Faculty Membership (outside USA, Canada & Mexico) $115.00Associate (for retired piano teachers) Membership (outside USA, Canada & Mexico) $95.00
Dues: ($):*

Payment Methods

Debit or Credit Card

First Name

Last Name

Credit Card Number

Security Code

Card Expiration

Please click one of the PayPal options to complete payment and submit the form.

Signature Page