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Name:
_____________________________________________________________________
Mailing Address:
_____________________________________________________________
City:
________________________________ State: _____________ Zip Code
___________
Phone Day:
_____________________________ Other _______________________________
What instruments do you play?
___________________________________________________
Briefly state your musical goals and
other information you would like to share:
____________________________________________________________________________________________________
____________________________________________________________________________________________________
What styles of music do you write? Please name all that apply:
1) Adult Contemporary 2) Advertising/Jingles 3) Alternative Rock 4) Blues 5) Bluegrass
6) Children's 7) Classical 8) Contemporary 9) Christian 10) Country 11)Folk 12) Gospel
13) Instrumental 14) Jazz 15) New Age 16) Pop 17) R & B 18) Rock 19) Other
____________________________________________________________________________________________________
I write Lyrics/Music/or
Both: ___________________________ I sing/try to sing/do not sing: _________________________
I like to co-write/I would rather write alone:
______________________________
Chose the membership that most fits
your needs:
Single New Membership $20/yr
____ Single Renewal Membership $10/yr ____
Family New Membership $30/yr ____ Family Renewal Membership $15/yr ____
Newsletter Only Member $12/yr ____
(1Mbr,Spouse & children up to 18)
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