Associate Membership Application Form

Please fill out and print:  
Today's date:
Applicant's first name:
Applicant's last name:
Applicant's e mail addr:
Applicant's address:
City:
State:
Zip:
Applicant's phone#:
Name of Business or Organization (if applicable):
Business Address:
City:
State:
Zip:
Business phone#:
Business e mail:
NOTE: Associate Members are not eliglible to vote in AMTL elections, hold AMTL offices or submit student performer applications for AMTL events.
Signature of Applicant:

Please print and send to:

Carol Dovan
AMTL Membership Chair
6 Hillview Ave.
Port Washington, NY 11050

Yearly dues $30 Payable Annually
Please submit with application form
 

Return to top
1