ACTKA | Membership Registration Form

ANNUAL MEMBERSHIP APPLICATION

In becoming an ACTKA member you are directly supporting ACTKA's programs and events in the ACT and surrounding region. You will also receive discounts at ACTKA events, workshops and masterclasses.

Name:

Address:

Postcode:

Telephone:

Mobile:

Website:

Email:

Confirm Email:

Your email details will be added to our mailing list in order to receive information about up-coming ACTKA events.

I am a (tick all that apply):

Music enthusiast

Piano student

Teacher

Professional musician

Other

How did you hear about ACTKA?

MEMBERSHIP CATEGORY

PAYMENT

Date:

NOTE: To register multiple people, including student members, please complete a separate membership form and payment for each individual (i.e complete the process multiple times, once for each member). You will need a unique email address for each member.

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