Current Member Information Change Form

You are required to fill in your first and last name on this form. Then only fill in the information that you want to add or change, leaving the other boxes blank.

Note: The bottom of this form will allow you to enter information for up to three emergency contacts. Two are required; the third is optional, Your first emergency contact should be someone who lives locally.

First Name

Last Name

Primary Band Instrument

Select one

Do you play any additional instruments?

Separate multiple instruments with commas

How long have you played your primary instrument?

Select one

Less than 5 years

5-10 years

11 or more years

Do you play in any other local musical organization?

Separate multiple organizations with commas

Occupation

Street Address

Enter full address including Apt # (if any)

City

State

Two-letter abbreviation

Zipcode

Cell Phone

(###)

###

####

Land Line Phone

(###)

###

####

Emergency Contact 1 Name

Please enter a local emergency contact

Emergency Contact 1 Phone

(###)

###

####

Emergency Contact 1 Relationship

Emergency Contact 2 Name

Emergency Contact 2 Phone

(###)

###

####

Emergency Contact 2 Relationship

Emergency Contact 3 Name

Emergency Contact 3 Phone

(###)

###

####

Emergency Contact 3 Relationship