2022-23 MBA Membership Application

2022-23 Membership Application

Effective through July 31, 2023
Full Name*

First NameLast Name
Pronouns*
Affiliation (School, University, Community Band, Company)*
Primary E-mail Address*

Confirmation Emailexample@example.com
Secondary E-mail Address

Confirmation Emailexample@example.com
Primary Phone #*
Secondary Phone #
Business Phone #
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
MBA Directory (password provided to members only)*

Include name, affiliation, & email addressInclude Mailing AddressInclude Phone NumberOther
I am a (please choose all that apply):

School Band TeacherUniversity ProfessorPrivate TeacherCommunity Band MemberOther
Where are you studying?
Where are you teaching?
Are you a Manitoba Teachers' Society Member?

YesNo
What percentage of a full time position do you teach?
What percentage of a full time position do you teach music/band?
As of September 1, 2022, how many years have you taught school band in Manitoba?
What grades are you teaching band?
Are you interested in being listed in the online Private Teacher Directory?

YesNo
As of July 2022, how many years have you taught privately?
Do you provide instruction in French?

YesNo
Do you provide instruction online?

YesNo
Primary Instrument

FluteOboeClarinetBassoonSaxophoneTrumpetFrench HornTromboneEuphoniumTubaString BassPercussion
Secondary Instrument

FluteOboeClarinetBassoonSaxophoneTrumpetFrench HornTromboneEuphoniumTubaString BassPercussion
Where in Manitoba do you teach (if in Winnipeg, indicate in which part of town)?
Professional website/page (to link to private teacher listing):
Which Community Band(s) do you perform with?
How many members are in your Community Band(s)?
Any additional information:
The MBA has adopted a Privacy Policy. Your application or registration for MBA's events or programs as a director, volunteer and/or applicant for a director or volunteer position is your consent to our collection, use, and disclosure of your personal information for the purposes and on the basis outlined in MBA's Privacy Policy. You hereby grant MBA the right and permission in respect of any audio, audiovisual or visual analog or digital recordings (of any nature or kind) of any rehearsal, performance or celebration connected with such event or program in which you or you and others are recorded, to use, reuse, publish and republish any such recording contemporaneously at the time of the recording and for a period of 10 years from the date of the recording, for promotional, fundraising, or educational purposes, without restriction as to alteration and without claim by you for compensation, damages, breach of privacy or libel.
MBA Privacy Policy:*

“I have read and agree to the MBA Privacy Policy”
Payment:*

Online (PayPal/Credit Card)
My Products
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MBA Membership

CMEA Membership (MBA Membership Required)

Donation
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MBA Membership

Individual Membership - General
$60.00CAD



Individual Membership - Senior (62+)
$35.00CAD



Individual Membership - Student
$20.00CAD



Community Band Membership
$60.00CAD



Corporate Membership
$95.00CAD



CMEA Membership (MBA Membership Required)

Add CMEA Membership Regular *Only available until October 31
$25.00CAD



Add CMEA Membership Retired *Only available until October 31
$18.00CAD



Add CMEA Student *Only available until October 31
$12.50CAD



Donation

Add a Donation to the MBA (Donations of $20 or more will receive a tax receipt)
$1.00CAD $ Amount
Item subtotal:$0.00CAD



Total

$0.00CAD
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2022-23 Membership Application