Membership Application for the Southern California Early Music Society
Enclosed is my check for $30 payable to SCEMS, please enter me as a full member of the Society.

Name
Address
City	State	Zip
Home Phone	Work Phone	Fax
Email	Web Site
Do you wish to be listed in the Membership Directory?		Please circle: Yes or No
May we release your name and address to other music organizations?		Please circle: Yes or No
Additional information for the Member Directory (optional): If more than one name on membership, please specify which member for each item.
Instruments Indicate instrument & level: beg, int, adv, pro, pro/tch	[1]	[4]
	[2]	[5]
	[3]	[6]
Voice Indicate voice part & level: beg, int, adv, pro, pro/tch	[1]
	[2]
Participation/membership in performing groups	[1]	[4]
	[2]	[5]
	[3]	[6]
Early Music Related Business/Service/Product name, description, phone	[1]	[2]
Other Music Related Affiliations faculty position, volunteer work, etc. Indicate organization, affiliation
[1]	[2]	[3]
Other Business Business/Service/Product name, description, phone	[1]	[2]

Mail this form with your $30 check payable to SCEMS to:
SCEMS, Post Office Box 41832, Los Angeles, CA 90041-0832