NCBA Eastern District Membership Registration 2018/2019
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.

Bob Pearson
E. A. Laney High School
2700 North College Road
WIlmington, NC 28405

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.

ADDENDUM: If you attend the Fall Retreat on Saturday, August 18, 2018 ALL day you will receive a FREE membership for the 2018/2019 year for the NCBA Eastern District.

Email address *
Please select whether you are a NEW or RETURNING member to the NCBA Eastern District. *
First Name *
Your answer
Last Name *
Your answer
NAfME Membership Number *
Your answer
NAfME Membership Expiration Date *
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/
DD
/
YYYY
School Name *
Your answer
School Level(s) Taught *
Required
School Street Address *
Your answer
School City *
Your answer
School Zip Code *
Your answer
County of Employment *
Your answer
School Phone (Format: 123-456-7890) *
Your answer
Preferred Email *
Your answer
Alternate Email
Your answer
Home Address *
Your answer
Home City *
Your answer
Home Zip Code *
Your answer
Cell Phone (Format: 123-456-7890) *
Your answer
How long have you been teaching? *
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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