Membership Application


EuroCASS Membership Application Form
Please print or type - *Delete where necessary:


Name:
Title:
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Do you play  *Clarinet/Saxophone?  *Professional/Amateur?
Do you teach? *Yes/No
Do you teach privately? *Yes/No
Do you teach in an institution? *Yes/No
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Address:
City:
Country:                                          Postal/Zip Code:
Phone:
Fax:
Email:
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Membership Rates (for Western Europe):
Individual full membership: £10 - Student membership: £5
Members are encouraged to make an additional donation to 'EuroCASS' when paying their annual fees.
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Fees Paid:
Contribution to EuroCASS:
Total Remittance:
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I enclose an international money order payable to 'EuroCASS' for:
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Please debit my *Visa/Mastercard
Card Number:
Expiry Date:
Name and Address of Cardholder:



Signature:

Please send this form to:

The Membership Secretary
Jørn Nielsen,
Kirkevænget 10,
DK-2500 Valby
Denmark

info@eurocass.org