Last Name: First Name: Street Address: Town/City: State: Nebraska Other Other: Zip/Post code: Home Phone: Cell Phone: Email Address: Directors Primary Instrument: Flute Oboe Clarinet Bassoon Saxophone Trumpet French Horn Trombone Euphonium Tuba Percussion Piano Voice Strings Directors Secondary Instrument: Flute Oboe Clarinet Bassoon Saxophone Trumpet French Horn Trombone Euphonium Tuba Percussion Piano Strings Voice Total Tears 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
School: Address: Town/City: State: Zip/Post code: School Phone: Fax:
Active ($65) Associate ($15) Student ($1) First Year Teacher (Free) Retired (Free)
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Please mail your check and printed Membership Form to:
Eric Snyder Lincoln Northeast High School 2635 N. 63rd St Lincoln, NE 68507 Bus 402.436.1303 Res 402.443-3837
esnyder@lps.org