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Local Association Report
Deadline: July 1 

Use the tab key or mouse to move between answer fields. Using the Enter key will submit your form.
Applicant Information
YearCurrent year
Association
 
Association Web SiteIf applicable
Form completed byName
*EmailRequired field
A confirmation email will be sent to this e-mail address. This email will be the contact email for the association if the president does not have an email address.
Office Held
Phone Number
Former Members
List members who are not renewing membership as of this year in the appropriate category below.
Deceased
Inactive
Moved
Other
Why?
Local Officers
President
Address
City
State
Zip Code
Phone Number
Email
 
Treasurer
Phone Number
Email
 
Certification Chair
Phone Number
Email
 
Independent Music Teacher Forum Chair
Phone Number
Email
 
Local Student Affiliate Chair
Phone Number
Email
 
Ensemble Chair
Phone Number
Email
 
Original Composition Chair
Phone Number
Email
 
Performance Chair
Phone Number
Email
 
Publication Chair
Phone Number
Email
 
Theory Chair
Phone Number
Email
 
World of Music Chair
Phone Number
Email
 
Other Officers
Local Membership Requirements
College Degree
Participation
Certification
None
Other
Please explain
 
Local Dues
 
Any other fees paid by teachers?
Yes
No
Please explain
 
Do you have Associate or Honorary members?
Yes
No
Please explain criteria
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