CBMA Membership

Carol Brice Music Association of NC Membership Application

Thank you for considering joining our branch of the National Association of Negro Musicians, Inc. Please complete the form below and select your appropriate level of membership. Please be reminded that membership and dues are annual and based on the NANM fiscal year: September 1 – August 31. Dues may be paid via check and made payable to the Carol Brice Music Association and mailed to: Gerald R. Knight, 1032 Edgewood Ave., Burlington, NC 27215
Full Name*

PrefixFirst NameMiddle NameLast NameSuffix
Physical Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Primary Phone Number*

Area CodePhone Number
Alternate Phone Number

Area CodePhone Number
E-mail*
Current Occupation
Musical Instrument
Other Skills
College/University (if applicable)
Membership Level

Adult Membership ($130)Collegiate/Young Artist Membership ($85)Youth/Junior Membership ($85)Life Membership ($2,060)
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Carol Brice Music Association of NC Membership Application