(Please Print Clearly)

Name: __________________________________________

Permanent E-Mail: ___________________________________________ Required to receive newsletters and information

Permanent Address: ______________________________________________________________________

City: _______________________________

State: _______________________

Zip: ________________________

Phone: ______________________________

Flute Teacher(s): _________________________________________________________________________________

Music Schools Attended: ___________________________________________________________________________

Check Musical Status: (no bios please)

Professional Orchestra or Ensemble
College Teacher
Private or Studio Teacher
Adult Amateur
Junior High/Middle School Student
High School Student
College Student (Undrgrad or Graduate) must be Full Time student for student membership
Corporate
		____________ $50 Adult Member
		____________ $25 Student Member
		____________ $50 Corporate Member (if not exhibiting)
		____________ $10 On-Site registration fee                                if not preregistered (Deadline to Pre-Register Jan 15)
		____________ Total (Check or Money Order made out to Florida Flute Association. NO CASH. Do not staple or tape checks to app)

MEMBER YEAR BEGINS ON FIRST DAY OF FLUTE CONVENTION, INCLUDES DUES & CONVENTION FEE

Mail To:	Florida Flute Association
	5726 Cortez Rd. West #261
	Bradenton, Fl 34210