Nebraska State Bandmasters Association

Membership Application

Send to:

Jeff Mount

Membership Chairman

Blair High School

440 N. 10th St

Blair, NE 68008

NAME_________________________________________________________

Last First

Home__________________________________________________________ ______ ________________

Mailing address Street City State Zip Area Phone #

School/District____________________________________________ FAX # _______ _______________

Area Phone #

School__________________________________________________________ ______ ________________

Mailing address Street City State Zip Area Phone #

Preferred email____________________________________ Cell Phone ______ ________________

Area Phone #

Class (Circle one) AA A B C D College

Job Description Instrumental Music: Elementary _______ MS _______ HS_______

College _________ First Year Director__________

Primary Instrument_________________________ Secondary Instrument_______________________________

Exhibitor__________ Friend_______ Total yrs. Teaching (not counting this year)_________

Active ($50)_______ Associate ($15) ______ Student ($1) _____ 1^st year (free)_______ Retired (free)________