Membership Enrollment Form | Bexley Music Parents

Parent 1 Information

Full Name *

First

Last Name *

Last

Email

Phone

Address *

Address

Street Address

Building/Suite/Apartment #

City

State/Province

Zip/Postal

Parent 2 Information

First Name

Last Name

Email

Phone

Address

City

State

Zip

Student 1 Information

First Name

Last Name

Graduation Year

Programs (check all that apply)

Band

Jazz

Choir

Orchestra

School

High School

Middle School

Elementary School

Bexley Music Yard Sign?

Yes, include graduation year

Yes, no graduation year

No sign

Student 2 Information

First Name

Last Name

Graduation Year

Programs (check all that apply)

Band

Jazz

Choir

Orchestra

School

High School

Middle School

Elementary School

Bexley Music Yard Sign?

Yes, include graduation year

Yes, no graduation year

No sign

Student 3 Information

First Name

Last Name

Graduation Year

Programs (check all that apply)

Band

Jazz

Choir

Orchestra

School

High School

Middle School

Elementary School

Bexley Music Yard Sign?

Yes, include graduation year

Yes, no graduation year

No sign

Enrollment Options

Membership Type

Family Annual Membership - $30 - Covers all members of family (within residence) for school year.

Family Lifetime Membership - $150 - Covers all members of family (within residence) for lifetime, and one free yard sign.

Additional Yard Signs
Your first yard sign is FREE with Lifetime Membership. Additional yard signs are $15 each.

Additional Donation Amount
Any amount welcome!

Total

Credit Card *

In addition to my membership dues, I am interested in volunteering for (check all that interest you):