(Print this page and mail your complete membership form to SMEA, Box 519 Cudworth SK, S0K 1B0)

SMEA MEMBERSHIP / DATA CONSENT FORM


The following information will be used to contact members for renewal and membership drive purposes, to send newsletters or journals, and to forward conference, program, services and professional development opportunities information.

A membership in SMEA also entitles you to a membership in the Canadian Music Educactors Association. Your name, address and membership catalogue will be shared with the CMEA. The SMEA is a Special Subject Council of the Saskatchewan Teacher's Federation and recieves grants based on membership. Your name, address, membership cactalogue and teaching Certificate Number will be shared with the STF. The SMEA receives funding from the Sask Lottery Trust. Your name, postal code and membership catalogue may be shared with SaskCulture Inc for advocacy purposes. Information gathered regarding individual members will be retained on database in the SMEA general office for a period of twenty-four months along with this signed and dated consent form.

MEMBERSHIP APPLICATION / RENEWAL FORM


name:_________________________________________________

address:_________________________________________________

_________________________________________________

_________________________________________________Postal Code _________________

Teaching Certificate Number (to verify STF membership)

home phone_________________________________________________

business phone_________________________________________________

email address_________________________________________________

fax number_________________________________________________

Type of Membership:
__________Regular $50
__________Associate $30
__________Retired $30
__________Student $15
__________Administrative $100
__________Parent/Group $25
__________Corporate $75
Areas of Interest:
__________Instrumental
__________Choral
__________Classroom
__________Mentor
__________Consultant
I am enclosing $__________ for membership fees.
(optional) I choose to be excluded from lists that may be disclosed to SaskCulture Inc. ____

Signature:_________________________________date:_______________