Membership Is Active for 12 Months Upon Receipt of Payment and Completed Form

Membership Form

Membership is active for 12 months upon receipt of payment and completed form.

Does not include local chapter dues.

Name:

Membership Number:

Current Chapter Affiliation (if any):

Address:

City, State Zip:

Phone:

E-mail:

I teach at (name of school):

I am a(n):

☐Classroom Music Teacher

☐Private Music Teacher

☐Church Musician

☐Music Therapist

☐University Professor

☐General Classroom Teacher

☐Band Director

☐Choir Director

☐Orchestra Director

☐Administrator

☐Student at

☐Other

Highest Level of Orff Schulwerk education:

☐Chapter workshops

☐Level I

☐Level II

☐Level III

☐Post Level III

☐Teacher Educator

☐No Levels

I work for a:

☐Public School

☐Title I Public School

☐Private School

☐Church

☐College/University

I teach:

☐Early Childhood

☐Kindergarten

☐1st Grade

☐2nd Grade

☐3RD Grade

☐4th Grade

☐5th Grade

☐6th Grade

☐7th Grade

☐8th Grade

☐9th Grade

☐10th Grade

☐11th Grade

☐12th Grade

☐Special Needs Students

☐Undergraduate students

☐Graduate students

☐Seniors

☐Other
I am a member of:

☐American Choral Directors Association

☐American Recorder Society

☐Carl Orff Canada

☐Dalcroze Society of America

☐Early Childhood Music and Movement Association
☐Gordon Institute of Music Learning

☐Musikgarten

☐National Association for Music Education

☐Organization of American Kodály Educators

☐State MEA

☐Other

Membership Categories:

☐One-year Membership$85 US mailing, $115 international mailing

☐Three-year Membership$215 US mailing, $305 international mailing

☐Student Membership*$25 US mailing, $55 international mailing

☐Online Student Membership**FREE

☐Retired Membership***$56 US mailing, $85 international mailing

☐Music Industry Member$120 US mailing, $150 international mailing

*available to full-time undergraduate and graduate students; copy of student ID and proof of full-time status required

**no subscription to The Orff Echo; available to full-time undergraduate and graduate students; copy of student ID and proof of full-time status required

***for those 55 or older and retired

I have added a tax-deductible contribution to support the AOSA Annual Fund in the amount of $.

This membership is being purchased as a gift by:

Method of payment:

☐Check enclosed payable to AOSA

☐Credit Card

☐MasterCard☐Visa☐AMEX☐Discover

Credit Card Number

Expiration Date

Amount to charge

Signature

Check as applicable:

☐I do not want my name sold to music industry/institutions.

☐I do not want my profile shown to other members in the online Directory.

☐I do not want my phone number shown to other members in the online Directory.

☐I do not want my e-mail address shown to other members in the online Directory.

Please return to:

American Orff-Schulwerk Association

147 Bell Street, Suite 300

Chagrin Falls, OH 44022

Fax: (440) 600-7332

E-mail:

Thank you for supporting AOSA.