Southeastern Historical Keyboard Society
2011 - 2012 Membership Application/Renewal, Contribution and CD purchase form
Fill out this form, click "Submit" and pay with credit card

Name:
Address:
City/State/Zip or Postcode:
Country (if outside USA):
Home Phone:
Work Phone:
Cell Phone:
E-Mail:
Professional Affiliation :
Specialties:
Your URL for link on SEHKS website:

Membership Types:
   Regular - $45.00$
   Student - $25.00$
   Organizational Affiliate - $45.00$
   Outside US Additional Mailing Fee - $5.00$

Membership Options:
   Joint membership (Midwestern Historical Keyboard Society) - Additional $10.00 $
   Joint membership (Western Early Keyboard Association) - Additional $10.00      $
   Family (extra person, same address)Additional $10.00$

Davitt Moroney Recital CD:
   Quantity @ $15.00 each $

Contributions:
    Jurow Endowment Fund - Harpsichord Performance $ 
    Martha Clinkscale Scholarship Fund - Student Conference Scholarship $ 
    General Fund $ 
 
TOTAL FOR MEMBERSHIP    $
When you click on Submit, your member info will be emailed to us. This blank page will display again. Then, click on appropriate blue bottons below to set up your payment. Follow cart instructions for credit card payment. $


OPTIONAL: Use your Credit Card for your membership and/or donations:
Regular Membership: $45.00
Student Membership: $25.00
Organizational Affilate: $45.00
Joint (Midwestern Historical Keyboard Society): $10.00
Joint (Western Early Keyboard Association) : $10.00
Family (extra person, voting rights, same address): $10.00
Outside US Additional Mailing Fee : $5.00
Davitt Moroney Recital CD: $15.00 each
 :
Jurow Endowment Fund - Harpsichord Performance

Martha Clinkscale Fund - Student Conference Scholarship


General Fund

©2011 Southeastern Historical Keyboard Society