Name: ___________________________________________________________

Address: _________________________________________________________

Address: _________________________________________________________

City:________________________ State:_______ Zip Code: ______________

Country: _______________________ E-mail address: ___________________

Phone: (______)___________________________________________________
Optional for publication in Membership Directory.
Circle only one:   Home   Office   Fax   Home/Fax   Office/Fax

___$50 Regular Membership
___$30 Full-Time Student Membership
       (Mail or Fax photocopy of full-time student ID or proof of age to treasurer's address below)
___ $30 Senior Membership (65 yr or older)
     (Mail or FAX photocopy of proof of age to treasurer's address below) 

___This application is for a NEW membership.
___This application is for a membership RENEWAL.

METHOD OF PAYMENT:
___CHECK enclosed payable to INTERNATIONAL TRUMPET GUILD.
Non-USA checks must be a draft on a US bank in US$, or by international money order.
 

___ VISA

___ MASTERCARD

___ AmEx

___ Discover


Name on Card: _______________________________

Signature: ____________________

Number: _____________________________________

Expiration Date: _____|_____|____

JOIN VIA FAX:
Fax completed form with Credit Card information to: 413-403-8899

JOIN VIA MAIL:
Mail completed form with check or Credit Card information to:
International Trumpet Guild
PO Box 2688
Davenport, IA 52809