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Collegiate Application

Collegiate Application

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Published by John Wilkins
2011-2012 APPLICATION FOR COLLEGIATE MEMBERSHIP MENC AND STATE MUSIC EDUCATORS ASSOCIATION MEMBERSHIP TERM: JULY 1, 2011–JUNE 30, 2012

1. q q

New Membership Renewal

5. Collegiate Membership Dues*

$ ______

PLEASE SEE REVERSE SIDE FOR COLLEGIATE DUES SCHEDULE

Membership I.D. # ______________________________

Membership dues are non-refundable and are not tax deductible as charitable contributions.

2. Indicate Preferred Mailing Address:
Name: _______________________________________ Street: _
2011-2012 APPLICATION FOR COLLEGIATE MEMBERSHIP MENC AND STATE MUSIC EDUCATORS ASSOCIATION MEMBERSHIP TERM: JULY 1, 2011–JUNE 30, 2012

1. q q

New Membership Renewal

5. Collegiate Membership Dues*

$ ______

PLEASE SEE REVERSE SIDE FOR COLLEGIATE DUES SCHEDULE

Membership I.D. # ______________________________

Membership dues are non-refundable and are not tax deductible as charitable contributions.

2. Indicate Preferred Mailing Address:
Name: _______________________________________ Street: _

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Categories:Types, Legal forms
Published by: John Wilkins on Jul 27, 2011
Copyright:Attribution Non-commercial

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09/07/2011

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2011-2012 APPLICATION FOR COLLEGIATE MEMBERSHIPMENC AND STATE MUSIC EDUCATORS ASSOCIATIONMEMBERSHIP TERM:
 
JULY 1, 2011–JUNE 30, 2012
 
1.
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New Membership
 
q
Renewal
Membership I.D. # ______________________________
 2. Indicate Preferred Mailing Address:
 Name: _______________________________________ Street: _______________________________________
(I using school box #, street address must be included.)
City: ________________________________________State: ___________________Zip: ________________Country (outside U.S. only): ______________________Phone (including area code): _____________________E-mail: _______________________________________
(Email address is required to access online benefts.)
NOTE:
MENC periodicals are mailed second-class and arenot orwarded by USPS. Please notiy MENC immediately(mbrserv@menc2.org) o mailing and email address changesto ensure receipt o publications.
3. Indicate College/University:
_____________Collegiate Chapter # (i known): ____________________ School Name: _________________________________School City: ___________________________________School State: __________________________________(Determines state ailiation.)
4. Indicate Expected Graduation Date:
Month/Year: _______ / ________
 
5. Collegiate Membership Dues*
$ ______
PLEASE SEE REVERSE SIDE FOR COLLEGIATE DUES SCHEDULE
 Membership dues are non-refundable and are not taxdeductible as charitable contributions.
6. Options:
 
m
Society or Research in MusicEducation $37.00 $ _____
(includes subscription to Journal of Researchin Music Education) 
 
MENC membership is a prerequisite.
m
Tax deductible contribution toFAME (see back or details) tosupport (select one): $ ______
m
Music in Our Schools Month
m
Advocacy
m
Teacher Recruitment and Retention
m
Student Programs
m
Wherever it’s needed most!
TOTAL ENCLOSED
$ ______ 
7. Membership Payment Options:
n
Visit MENC online: www.menc.org
n
Contact MENC Member Services:TELEPHONE: 1.800.828.0229; 703.860.4000
(outside U.S.)
FAX: 1.888.275.6362
(toll ree)
; 703.860.2652
(outside U.S.)
n
Return orm with payment to:MENC Collegiate Membership1806 Robert Fulton DriveReston, VA 20191 USA
 
Make checks payable to MENC (US currency only) or usecredit card (below). Please do not send cash.Please charge my (check one)
q
MasterCard
q
VISA
q
American Express
q
DiscoverName on credit card: ________________________________________________________________________________Credit Card No. _____________________________________________Exp. Date: ______________________________Signature
X
_______________________________________________________________________________________

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