Music Theory Midwest

Membership Registration Form

                     2008

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: $_______



MTMW Home: http://www.wmich.edu/mus-theo/mtmw


  http://www.wmich.edu/mus-theo/mtmw/mtmw_mem.html 
Revised: 03.mar.08