American Choral Directors Association Membership Renewal and Application
Print clearly or type. New Membership Membership Renewal - Member Number: ___________________
______________________ ______________________ ______________________
FIRST NAME MIDDLE NAME LAST NAME
Home Address
Office Address
Address: _____________________________ Primary Address
  _____________________________
City: _____________________________
State: _____________________________
Zip: _____________________________
Country: _____________________________
Phone: _____________________________
Email: _____________________________
Fax: _____________________________
Address: _____________________________ Primary Address
  _____________________________
City: _____________________________
State: _____________________________
Zip: _____________________________
Country: _____________________________
Phone: _____________________________
Email: _____________________________
Fax: _____________________________
Membership Type (mark one) Choir Types (mark all that apply) Activity Areas (mark all that apply)
Active US/Canada - $ 85
Associate - $ 85
Student - $35
Retired - $45
Institutional - $110
Industry - $135
Foreign Active Airmail - $110
Life ($200 Installments) - $2000
Installment Amount: $ __________
* Canadian Fees same as U.S.
Boys
Children
Ethnic & Multicultural
Girls
Jazz
Men
SATB/Mixed
Show
Women
* Primary Choir Type __________________
ACDA Student Chapter
College/University
Community
Elementary
Jr. High/Middle School
Music In Worship
Professional
Sr. High School
Supervisor/Administrator
Two-Year College
Youth & Student Activities
* Primary Activity ____________________
Statement
Application Submission Instructions
As an ACDA member, I will comply with the copyright laws of the United States of America as they pertain to printed music or the downloading of music off the internet. (Compliance with these laws is also a condition of participation by clinicians and performing ensembles that appear on any ACDA sponsored event or convention.) Please print this application, fill it out completely and remit with a Check, Money Order, or Credit Card in US Dollars payable to ACDA. Fax form to (405) 232-8162 or mail form to:
ACDA
ATTN: MEMBERSHIP
PO BOX 2720
OKLAHOMA CITY OK 73101-2720
Payment Options

Please Select Payment Type:   Check #______________________ (enclosed)     Discover        MasterCard        Visa

Credit Card #: ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___      Expiration Date: ___ ___ / 20___ ___ (Month/Year)

 Name of Card Holder: ________________________________________________ CVV2 Code ___ ___ ___

Card Holder Billing Address: ________________________________________________________________________________

_________________________________________________________________________________________________________

Signature:________________________________________________________ Date: ____________
I agree to pay above total amount according to card issuer agreement and acknowledge all sales are final unless duplicate payment is made.

Revised June 2008 © ACDA