NCBA Eastern District Membership Registration 2021-2022
Please do not forget to postmark your membership registration fee of $10 ($75 after October 1st) to the NCBA Treasurer at the following address before the October 1st deadline.

Make Checks payable to: NCBA Eastern District

Beverly Goehring
111 Sts. Delight Ch. Rd.
New Bern, NC 28560

NOTE: REGISTRATION IS NOT CONSIDERED TO BE COMPLETE UNTIL BOTH FORM AND PAYMENT HAVE BEEN RECEIVED. THE REGISTRATION BECOMES $75.00 AFTER OCTOBER 1st. LATE REGISTRATION MUST BE MADE TWO WEEKS PRIOR TO THE PRE-REGISTRATION DATE (30 DAYS IN ADVANCE) FOR PARTICIPATION IN THAT EVENT.

***If you are retired, please put "N/A" in the required sections you cannot answer, or "0" in any numeric required answer.***
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Email *
Please select whether you are a NEW, RETURNING, or RETIRED member to the NCBA Eastern District. *
First Name *
Last Name *
NAfME Membership Number *
NAfME Membership Expiration Date *
MM
/
DD
/
YYYY
School Level(s) Taught *
Required
School Name *
School Street Address *
School City *
School Zip Code *
County of Employment *
School Phone (Format: 123-456-7890) *
Preferred Email *
Alternate Email
Home Address *
Home City *
Home Zip Code *
Cell Phone (Format: 123-456-7890) *
How long have you been teaching? *
Does the classes the you teach offer at least one credit to the students taking them? *
What type of ensembles do you teach? (check all that apply) *
Required
What instrument are you most qualified to judge? i.e. What is your major/primary instrument? *
What secondary instrument are you most qualified to judge? i.e. What instrument have you had some experience playing? *
A copy of your responses will be emailed to the address you provided.
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