Nebraska State Bandmasters Association
Membership Application

Last Name

First Name

Home Information
Home Street Address

Home City

Home State Nebraska Other Other

Home Zip

Home Phone

Cell Phone

School Information

Name of School/District

School Street Address

School City

School State Nebraska Other Other

School Zip

School Phone

School Fax Number

Email

Primary Job Description
Secondary
Middle Level
Elementary
College
College Student
Exhibitor
Friend

College Student: Year In School
N/A Senior Junior Sophomore Freshman

Classification for Secondary Teachers Only
AA
A
B
C
D

Other Assignments (Select as many as necessary)
Secondary
Middle Level
Elementary
College
First Year Teacher

Directors' Primary Instrument Flute Oboe Bassoon Clarinet Alto Saxophone Tenor Saxophone Trumpet French Horn Trombone Euphonium Tuba Percussion Piano Voice Other

Secondary Instrument Flute Oboe Bassoon Clarinet Alto Saxophone Tenor Saxophone Trumpet French Horn Trombone Euphonium Tuba Percussion Piano Voice Other

Total Years Teaching (Not counting this year) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50

Dues
Active ($50) Associate ($15) Student ($1) First Year Director (Free) Retired (Free)

Make Checks payable to NSBA
Print completed form.
Please mail check and form to:

Dan Sodomka
Aurora High School
300 L Street
Aurora, NE 68818

Bus 402.694.6966
Res 402.384.5671
dsodomka@esu9.org