Membership Registration Form |
Name (title): ________________________________________________________________
Address: ___________________________________________________________________
___________________________________________________ Zip:_____________
Telephone: (o) _________________ (h) _________________ Email: ____________________
Academic Affiliation: _________________________________________________________
2007 membership dues:
Regular - $15; Joint (two members, one address)
- $20; Student/Emeritus - $10. $______
Donation to Arthur
J. Komar Student Award fund
$______
[ ] Check here if you wish the donation to be kept anonymous
Please make cheque payable to "MTMW" and send along with this form to:
Gretchen C. Foley, MTMW Treasurer
University of Nebraska-Lincoln
230 Westbrook Music Building
Lincoln, NE 68588-0100
Your cancelled cheque will be your receipt.
Total amount enclosed: $_______
http://www.wmich.edu/mus-theo/mtmw/mtmw_mem.html Revised: 03.mar.08