Membership Form

Australian Society for Music Education Incorporated
ABN 53 106 346 200

Please use this form to apply for ASME membership. If you prefer to post or fax your application, please use the downloadable PDF Membership Form.

Title
Given Name
Surname
Contact Address
Suburb
State
Country
PostCode/Zip
Telephone
Facsimile
Email
Work Place/Institution
Please check no more than three boxes. Choose categories which best describe your current status.
Teacher School-Based	Early Childhood Generalist Early Childhood Music Specialist Primary Classroom Primary Music Specialist Middle School Secondary Class Music Instrumental/Vocal Teacher Instrument/s
School System	Government Independent
Teacher Private/Self-Employed	Studio Teacher Instrument/s Community Classes
Education System Officer	Curriculum Advisor/Writer Administrator Other
Tertiary	University TAFE/Adult Education
Concessional Members	F/T Student, ID No. Institution Retired
Music Organisation/Industry	Composer Performer Education Officer Other
I would like to receive:	ASME e-news ASME Update electronically ISME e-news
Type of Membership	Full $75.00 Concession $30.00 (Fulltime students, retirees)
Credit Card Type	Mastercard Visa
Credit Card Number
Name on Card
Expiry Date	MM YY

ASME website: http://www.asme.edu.au Email: asme@asme.edu.au