Individual Membership Form Secure membership registration available online at www.pas.org

Please complete and return all three pages of the membership form.

Member Information Have you ever been a PAS member before? p Yes, Member # ______p No

Prefix _____ First Name ______Middle Initial _____ Last Name______

Suffix _____ Designation ______(PhD, AMTA, CBMT, etc.) Informal Name ______

Gender _____ Date of Birth _____/_____/_____ p Professional Membership p Student Membership Current Grade: p College/University: Undergraduate ______p Middle School p College/University: Graduate Organization/Company/School Name p High School p College/University: Post-Graduate

______Title School Name

Mailing Information

Primary Address p Home p Work p Alternate Secondary Address p Home p Work p Alternate Use this address for: p Mail p Billing p Shipping Use this address for: p Mail p Billing p Shipping

Address ______Address ______

Address ______Address ______

City______City______

State ______State ______

Zip/Postal Code ______Zip/Postal Code ______

Country ______Country ______

Communication Work Telephone ______Fax ______

Home Telephone ______Email ______

Mobile Telephone ______Alternate Email ______

Website ______Alternate Website ______

Please remove my name from the following PAS methods of communication: p PAS Email Newsletters p Chapter Communications p PAS Announcements p Industry Mailings*

*PAS makes member addresses (excluding telephone and email) available to vendors who provide products and services to the PAS community. We are committed to delivering relevant information and resources to our members. By answering these questions, you will help us target member benefits and communication to your interests.

What are your interests and specialties? Select all that apply p Career Development p Health/Wellness p Percussion Ensemble p Symphonic/Orchestral p Composition p Keyboard Percussion p Recreational Music p Technology p Contests/Competitions p Marching Percussion p Research p Vintage/Collector p Drum Circles p Military Ensemble p Scholarships/Grants p World Music p Drumset p PAS Museum/Library p Steel Band p Other ______p Educator Resources p PASIC p Student Resources

In which activities do you currently participate? Select all that apply p Clinician p Indoor Marching Percussion p Research p Symphony/Orchestra p Community Band/Orchestra p Jazz Ensemble p Rock Band p World Music Ensemble p Concert/Symphonic Band p Marching Band p Soloist p Other ______p Drum Circle p Percussion Ensemble p Steel Band p Drum Corps p Recreational Music p Studio/Technology

Which activities do you currently teach/conduct? Select all that apply

p Community Band/Orchestra p Indoor Marching Percussion p Recreational Music p Studio/Technology p Concert/Symphonic Band p Jazz Ensemble p Research p Symphony/Orchestra p Drum Circle p Marching Band p Rock Band p World Music Ensemble p Drum Corps p Percussion Ensemble p Steel Band p Other ______

PAS needs volunteers throughout the year to fulfill its mission. What are your volunteer interests?Select all that apply p Audio/Visual p Committee Participation p Judge/Adjudicator p PAS Museum/Library p Chapter Organization p Fundraising p Logistics p Photography p Clinician p Hospitality p PASIC (PAS Museum/PASIC)

What is the highest education level you’ve completed? Select one p High School p College/University: p College/University: p College/University: Undergraduate Graduate Post-Graduate p Other ______

What type of educator are you? Select all that apply

p Early Childhood p Middle School p College/University: p Percussion Specialist Undergraduate p Elementary School p High School p College/University: Graduate p Private Instructor and Post Graduate

What was your primary area of study in college? Select all that apply p Composition p Music: Business p Music Education: Other p Performance: Percussion p Ethnomusicology p Music: General p Music Therapy p Performance: Other p Fine Arts p Music Education: Percussion p Other ______Membership Type Select one ePAS: ePAS memberships provide online access to all PAS publications and resources. Hard copy: Hard copy members will receive PAS publications in the mail in addition to online access to all PAS publications and resources.

p Student Memberships p ePAS $35.00 Full-time students at all educational levels. p Hard copy $60.00 p p Professional Memberships p ePAS $60.00 Anyone in a percussion-related career or who has an interest in drums and percussion p Hard copy (educators, artists, etc.) p Hard copy $100.00

p Senior Citizen Membership $60.00 Professional hard copy membership for anyone 65 years and above. p Friend Membership For PAS advocates. Membership includes one Professional hard copy membership, a $175.00 $75 tax-deductible donation to PAS, and recognition in each issue of Percussive Notes.

Charitable Donations Through your additional financial support, PAS will continue to develop member benefits and award more than $35,000 each year to percussion students throughout the world. Please consider tax deductible donations to any of the funds below:

PAS Funds and Scholarships PASIC Scholarship Funds PAS Endowment Fund $ ______Avedis Zildjian Co. $ ______PAS Library Endowment Fund $ ______Cloyd Duff $ ______PAS Museum Acquisitions Fund $ ______George P. Contreras $ ______PAS Museum Endowment Fund $ ______James A. Sewrey $ ______PAS Museum Operations Fund $ ______Ludwig Industries $ ______Ralph Pace Museum Acquisition Fund $ ______McMahon Foundation $ ______PAS/Zildjian Family Opportunity Fund $ ______Maurie and Jan Lishon/Frank’s Drum Shop $ ______PAS/Remo, Inc. Fred Hoey Remo, Inc. $ ______Memorial Scholarship Fund $ ______Steve Ettleson $ ______PAS/Sabian, Ltd. Larrie Londin Thomas Siwe $ ______Memorial Scholarship Fund $ ______Val and Venus Eddy $ ______PAS/Armand Zildjian Scholarship Fund $ ______William F. Ludwig, Jr. $ ______Yamaha Corporation of America $ ______

Payment

_____ Check/Money Order [Make checks payable to Percussive Arts Society. U.S. funds drawn on a U.S. bank only] Membership $______

_____ VISA _____ MasterCard _____ Discover _____ American Express Donation $______Name on Credit Card ______International Card Number ______Shipping $______Expiration Date ______/______CID Code (3-4 digit code) ______(Outside North America) Signature ______Standard: $10.00 Please indicate how you received this application form Priority Air: $30.00 ______

Please allow 2 to 4 weeks for processing. Dues to the Percussive Arts Society are not deductible as charitable contribu- Total $______tions for federal income tax purposes. However, PAS dues may qualify as business expenses subject to restrictions im- posed by the Internal Revenue Code. Donations to the Percussive Arts Society are tax deductible as allowed by the IRS.

Online: www.pas.org/join . Mail: 110 W. Washington Street, Suite A, Indianapolis, IN 46204 Phone: 317.974.4488 Fax: 317.974.4499