(Please Print Clearly)

Name: __________________________________________

E-Mail: ___________________________________________ Required to receive newsletters and information

Address: ______________________________________________________________________

City: _______________________________

State: _______________________

Zip: ________________________

Phone: ______________________________     Cell 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 Student
High School Student
College Student (Undrgrad or Graduate) must be Full Time student for student membership
Corporate
		____________ $50 Adult Member
		____________ $25 Student Member
		____________ $10 Guest of Member
		____________ $50 Corporate Member (if not exhibiting)
		____________ $10 Main Concert Only                                   Fri.          Sat.
		____________ $10 On-Site registration fee                                if not preregistered (Deadline to Pre-                                Register Jan 15)
		____________ Total (Make check out to Florida Flute Association)

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