Schubert Club Membership Form

Become a Member of the Schubert Club

Instructions:
Use this form to renew your membership, and to confirm your contact information for the yearbook.
Fill in the fields below, select your Membership Type and additional programs, and click Submit.
Then follow the instructions that follow.

First Name:
Last Name:
Address:
City:
State:
Zip:
Telephone Area Code:
Telephone:
Email:
Retype Email:

Select Membership Type:

Regular Member

$40.00

Spouse or Partner Membership (Couple)

60.00

Sponsor Member

60.00

Patron Member

85.00

Benefactor Member

150.00

Life Member

400.00

Please check each of the following programs in which you wish to participate in the coming year. Any that you select will be listed beside your name in the Yearbook.

Schubert Club Workshop		$10 fee
Ensemble Singers		$10 fee
Duo Pianists		$10 fee
Piano Ensemble		$10 fee

Please check other programs you participate in. Any that you select will be listed beside your name in the Yearbook. These programs are free-of-charge.

Chorale		No Charge
Teachers Council		No Charge
Professional Development		No Charge
Piano Teachers Roundtable		No Charge

Please select all that apply. Will appear beside your name in the Yearbook. Note: if you play an instrument other than piano, you may enter in the 'Other' category, below.

Piano - performance
Piano Teacher
Organ - performance
Organ Teacher
Voice - performance
Voice Teacher
Composition
Other

If you have any comments, questions or concerns, please enter in the field below, or send an email to rk.leslie@gmail.com. Thanks for taking time to register!

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