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Early Music Society of Victoria, Inc -   Membership Application Form

New Membership & Membership Renewal

July 1st 2018 - 30th June 2019

Name (s)

(family - list parents & children u/18 who wish to be included in the membership that are under the same email address)

Address

Phone:                                                                  Postcode: ____________

 Email address: (please print clearly in large lowercase):

I / We apply for membership of the Early Music Society of Victoria, Inc 

Signature                                                                                                 Date

Please circle:         New membership                 Renewal        

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 If you wish, please add your musical interests so we can better accommodate you:    circle as appropriate

  Listener           Scholar              Teacher                  Instrument maker         Player/Singer

Instrument(s) played .................................................................................................................................... 

        Please include standard   B=Beginner   I= Intermediate    A=Advanced          P=Professional    T=Teacher     

Singers -  circle as appropriate:         

                                                                            Soprano              Alto            Tenor     Baritone   Bass    

Singing standard:   Beginner (can't read music);                          Intermediate (reads music, but can't sight-read);

                              Upper intermediate (sight reads with help);   Advanced (good sight-reader, sings in choir);   

                                                       Professional                                                      Teacher

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PAYMENT

CHEQUE

I enclose a cheque for $10.00  made payable to the Early Music Society of Victoria, Inc. Please send your completed form and payment to:

The Membership Secretary, 

EMSV Inc, PO Box 100, Park Orchards, Victoria, 3114

                                                                                                or

DIRECT DEBIT

Pay by direct debit to account: The Early Music Society of Victoria Inc

   CBA:   BSB No 063-001     CBA Account no 00908428

Under receiver account description add EMSV - xxxxx (your surname).

Also if paying by direct debit, please email the Membership secretary Peter Hawkins emsvofvic@gmail.com   your details as above and include the date of your direct debit.  

Note, the EMSV no longer accepts credit card payments.

Enquires to the Membership Secretary, emsvofvic@gmail.com or 03 9876 5210 or 0407 765 220.