OHIO FEDERATION OF MUSIC CLUBS

JUNIOR DIVISION

JUNIOR CLUB MEMBERSHIP

□ RENEWAL □ NEW

Please complete this form (Print or Type)

Send completed form and a check or Money Order (payable to OFMC) to the state Jr. Division treasurer,

Karl Morris, 200 Country Club Dr. SE, Warren, OH 44484-4660 Email: jkmorris200@embarqmail.com

Date

Club Name: Counselor:

Address: City & Zip Code:

Phone No: ( ) E-Mail Address:

No. of Jr. members: Festival District (circle one): 1A 1B 1C 1D 2 3A 3C 3D 3E 3F 3G 4A 4B

DUES:

Ø New club with 20 members or less $40 $_________

Number of additional members: ________ @ $1.50 each = $_________

Ø Renewing Clubs

20 members or less paid by November 30 $30 $_________

20 members or less paid between Nov. 30 & Jan. 15 $40 $_________

20 members or less paid after January 15 $45 $_________

Number of additional members: ________ @ $1.50 each = $_________

PUBLICATION: Annual dues include one subscription (3 issues) of Junior Keynotes.

Additional copies of Junior Keynotes may be ordered as follows:

Junior Keynotes No. @ $5.00 each = $

10 or more sent to one address. No. @ $4.50 each = $

MEMBERSHIP CARDS: Send stamped (60¢ postage) self-addressed business-sized (4” X 10”) envelope for every

20 cards. (Smaller envelopes require 85¢ postage because of thickness.) Number requested

Ø Teacher's membership: All teachers who are entering students in any OFMC and NFMC events must be members of the Federation, either in a local senior (adult) club, as a Senior Special (individual) member or as a life member.

Ø Name of the senior club you are member of:

□ I am not a member of a senior music club and will submit my Senior Special dues with the form

designated for that purpose.

□ I am a life member of OFMC and NFMC.

TOTAL AMOUNT ENCLOSED: $

*This form may be photocopied.