2024-25 Formulaire d'adhésion APMQmta Membership application

Quebec Music Teachers' Association

Official Membership Application Form
2024-25 Memberhips Application

Membership and insurance coverage take effect upon reception of annual membership dues*, and are valid until August 31, 2025, regardless of the start date.

Membership dues are $150 per year.

*First-time membership applications must be approved by the QMTA committee. Applicants will be notified of their membership status within three business days. In the event of a declined application, the full membership fee will be refunded.
E-mail 1*
For QMTA communications
E-mail 2
For students/clients, if different from the above
Salutation*

Mr.Mrs.Ms.Dr.NoneOther
Full Name (Surname first)*

Surname (last/family name)Forename (first/given name)
Post-Nominal Initials (B.A., M.Mus, PhD, etc.) (if any) to appear on the membership card
Maximum 2, representing your highest degrees/awards.
2024-25 — Type of Registration*

APPLICATION for new membership — FIRST-TIME memberRENEWAL of existing memberhip — I WAS a member in 2023-24REINSTATEMENT of past membership — I was a member BEFORE 2023

Membership Status*

ACTIVE (FULL) Membership (Registered Music Teacher).PROVISIONAL Membership (This status must have been previously conferred by the QMTA)FRIEND of the QMTA (This status is restricted to non-music teachers as well as retired or inactive music teachers).
Preferred Language of Communication*

EnglishFrench
Date of Birth*

yyyymmdd
Postal Address*

Apartment/Suite — Civic No.

Street type Street name

Municipality/CityProvince

Code postal
Primary Phone Nº*
Alternate Phone Nº
Current Website (if applicable)
Complete URL (including http(s):// prefix)

Uploading Section

Please disregard if not applicable
FIRST-TIME MEMBERS, and RENEWING/REINSTATING MEMBERS WITH NEW DIPLOMAS (conferred in or after 2023): Upload copies of diplomas/transcripts here.

Browse Files
Accepted file types: document (DOC/X), image (JPG, PNG 900 px +), portable file (PDF). Cancelof
Upload your photo and/or bio here

Browse Files
Accepted file types: document (DOC/X), image (JPG, PNG, 900 px +), portable file (PDF). Maximum 2 files. Cancelof

Membership Level & Annual Dues (EARLY BIRD SPECIAL)*

$ 150 — Active Member (Registered Music Teacher/full membership)$ 140 — Provisional Member (Status conferred by the QMTA to teachers not yet eligible for full membership).$ 50 — Friend of the QMTA (non-teacher)
Payment Method. Payment of annual dues must follow with the form.*

Mail-in cheque, payable to Quebec Music Teachers' Association, 3870 rue Labelle, Saint-Hubert, Quebec, J3Y 7T6Interac® e-Transfer to tresoriere@apmqmta.orgPayPal™. Go to Paypal.me/APMQMTACredit card

Name of payer, as shown on the transaction record.*
If you notice any discrepancies on your financial statement, please do not dispute or oppose payment. Instead, kindly contact our treasurer at treasurer@apmqmta.org for assistance. Note that the name on your statement will resemble 'Association des professeurs de musique du Québec, inc./Quebec Music Teachers Association Inc.' "

CREDIT CARD PAYMENT - PAIEMENT PAR CARTE DE CRÉDIT

Active Membership | Adhésion de membre actif($150.00CAD one-time payment)

Provisional Membership | Adhésion de membre provisoire($140.00CAD one-time payment)

Friend Membership | Adhésion de membre ami($50.00CAD one-time payment)

Total $0,00CAD

Validation*

Please accept my application/renewal/reinstatement as a member of the Quebec Music Teachers' Association, until September 1, 2025. I certify that all information provided in this application is accurate. This constitutes a signature.
Should be Empty:

Quebec Music Teachers' Association