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NER-AMTA's Membership Support/Pay It Forward Application
Please fill out the following form to complete your submission for the NER-AMTA's Membership Support/Pay It Forward Application.
Contact
membership@musictherapynewengland.org
with any questions.
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* Indicates required question
Email
*
Your email
NAME:
*
Your answer
Where do you live in the New England region?
*
Connecticut
Massachusetts
Maine
New Hampshire
Rhode Island
Vermont
MUSIC THERAPY CREDENTIALS:
*
MT-BC
CMT
ACMT
RMT
Additional Credentials
Your answer
Have you ever been an AMTA member in the past?
*
Yes
No
If yes, how many years ago?
Your answer
What is your current employment status?
*
Full-time
Part-time
Not currently employed
How many hours a week are you working as a music therapist?
Your answer
Please check the amount YOU are able to contribute towards the cost of your membership.
*
The full cost of professional membership is $250.
80% = $200.00
70% = $ 175.00
60%= $150.00
50% = $125.00
40% = $100.00
30% = $75.00
20% = $50.00
If you are a first or second year professional, please confirm you have requested your Welcome to the Profession Intern Packet from AMTA.
*
If you do not have a Welcome to the Profession Intern Packet from AMTA, you can request one here:
http://www.musictherapy.org/careers/packets/
Yes, I have received my Welcome to the Profession Intern Packet
No, but I have requested one via the link provided in this description
I am not able to apply any additional coupons to this year's membership fee
If you have check yes, what is the amount of your coupon that will be applied to this year's membership fee?
Your answer
How can you pay your membership forward in a non-financial way?
*
Please check two ways to "Pay it Forward".
Volunteer time to serve NER -AMTA.
Volunteer to help at the NER Conference.
Serve on a task force for the region or on your state advocacy task force.
Present at local high schools in your community to recruit future music therapists.
Sponsor a ‘Music Therapy Day’ at your workplace to advocate for music therapy.
Provide a professional In-Service/Presentation about Music Therapy and its benefits.
Share a testimonial about how an NER-AMTA membership impacts you and your clients.
Support the Fundraising Task Force- host a fundraiser or help to brainstorm ideas.
Support Membership Committee by making phone calls for a membership drive.
Submitting a proposal for a presentation or a CMTE at the NER Conference.
Submitting a proposal for an interdisciplinary conference.
Donate a Day to AMTA and NER by meeting with your local representatives.
Other:
Required
Please identify one person to whom the Committee can contact as a personal or professional reference. Include the person's: 1) Name 2) Email address 3) Telephone number.
*
Your answer
PERSONAL STATEMENT SECTION
PAY IT FORWARD NARRATIVE SECTION
Please write in paragraph form.
Why do you want to be a member of the NER and AMTA?
*
Your answer
What do you want to get out of being a member?
*
Your answer
How will being a member impact your professional life or your work in the field?
*
Your answer
Is there anything else you would like mention?
*
Your answer
The Committee asks that each award recipient complete their pay-it-forward task(s) and submit a short summary by December 5, 2021. These short summaries are to be emailed to Mark Fuller at:
membershipsupport@musictherapynewengland.org
. This will help us gather feedback, add new ideas to how other MT-BCs can Pay It Forward in future years, and support the continuation of this new program. Do you agree to this?
*
Yes
Required
Names of recipients of Pay It Forward grants must be shared with AMTA in NER’s annual 990 report for tax purposes. Do you agree to this?
*
Yes
Required
NER-AMTA cannot guarantee anonymity after the blind review process is complete and grant decisions are finalized. Do you agree to this?
*
Yes
Required
A copy of your responses will be emailed to the address you provided.
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