Membership Form Acton Community Chorus Spring 2014 Name: _________________________________________________________________________ Mailing Address: _________________________________________________________________ Phone: _________________________ Work/Cell Phone:_________________________________ Email: _________________________________________________________________________ Please indicate your voice part: Soprano ____ Alto ____ Tenor ____ Bass ____ Name as you wish it to appear in concert program: _______________________________________ Name as you wish it to appear on rehearsal name tag: _____________________________________ Birthday Month: _____________________ Year Joined ACC (if known) _________________ (Optional for monthly members’ birthday celebration) Membership Fees: (Please check one) Full Payment on joining: $75 per season – Standard Membership Dues $65 per season – Senior Membership Dues ______ ______ Installment Plan Standard: $25 Paid by February 10 $25 Paid by March 10 $25 Paid by April 14 ______ ______ ______ Installment Plan Senior: $25 Paid by February 10 $20 Paid by March 10 $20 Paid by April 14 ______ ______ ______ Incentive Plan ______ For scholarship information please contact Chorus President, Margaret Decker, or any board member. ______ Optional contribution to ACC: Date: _________________ Total Paid: ______ The Acton Community Chorus is a non-profit corporation. If your employer has a matching gifts program please provide the name of the company: ____________________________________________ How did you hear about the chorus? ___________________________________________________ The Acton Community Chorus loves to take photos! As a member, your photo may appear on our promotional material (including but not limited to posters, web page, advertisements, Facebook page, etc.). If you do not wish to participate in photography, please check below: No Photography Please