Application for Membership

Data For Guild Files
Minimum Age--18 years

Rejoining Member: Yes(  )No(  )
New Member: Yes(  )No(  )
Name: (Dr., Mr., Mrs., Ms.)_________________________________
Street:_____________________________________
City:______________________________________
State:______________________________________
Zip:_______________________________________
Home Phone:(___)___________________________
Work Phone:(___)___________________________
Email Address:_____________________________
Audition Center (or nearest metropolitan area):___________________________________

Please complete the above data carefully. Additional information:

Piano study with:__________________________
Where studied and degree (if any): _______________________________________
Number of years teaching piano:____________

I herewith apply for active membership in the National Guild for the 20__ fiscal year, ending June 30th thereof, for which I am enclosing the USA annual dues of $85.00 (Canada & Mexico $95.00; Foreign $110.00).

I have read the privileges of Guild members as published in the Guild Syllabus.

Signed: ____________________________________

Mail to:
National Guild of Piano Teachers
Teacher Division of The American College of Musicians
P.O. Box 9469
Austin, Texas 78766-9469

Rejoining Members:  Please indicate name under which previous membership appeared: _________________

New Members:  I have been referred by: _____________________________________