DCMEA Membership Form
Current, Retired, and Private Teacher Membership Form: 2019-2020, renewed annually
My information is the Same As Last Year (If "NO" please continue to fill out the rest of the form. If "YES" you are DONE!)
Email for DCMEA Newsletter and information:
Home Address Line 1
Street Name, Apartment
Home Address Line 2
City, State, Zip
School District (please choose one):
Our Lady of Lourdes
St. Martin de Porres
If you answered "Catholic or Other" for school district please list your school here.
Ex: (area code) 555-5555 *include ext. if applicable
Grade Levels Taught (Check all that apply)
Subjects Taught (Check all that apply)
DCMEA Festival Participation (Check all that apply)
Elementary All-County (Grades 5-6)
Junior High All-County (Grades 7-9)
Would you like to be listed as a private teacher?
If YES, list instrument(s)/voice that you teach privately:
Contact Phone for Private Teachers
Contact Email for Private Teachers
Would you like to be listed as an accompanist?
Contact Phone for Accompanists
Contact Email for Accompanists
Would you like to be listed in the DCMEA Online Directory? (Restricted access area)
Membership Fees (check one):
I am a public/private school teacher in Dutchess County: fees paid by district
I am a retired public school teacher: $10.00
I am a private studio teacher and/or accompanist: $12.00
I am a public/private school teacher outside of Dutchess County: $12.00
MEMBERSHIP FORM AND MEMBERSHIP FEE DUE no later than: September 30th, 2019
Forms received after this date cannot be guaranteed to be listed in the 2019-2020 Directory
RETURN APPLICABLE DUES CHECK PAYABLE TO DCMEA TO:
Geralyn Ely, Treasurer
19 Buttonwood Lane
Rhinebeck, NY 12572
Membership Form/Directory Questions:
Lisa Esposito, Membership Chair
A copy of your responses will be emailed to the address you provided.
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