Member Information Form - Pittsburgh Chapter of American Harp Society

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Checkboxes

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Member's Name

Enter the member's first and last name here.

Member's Primary Phone Number

Please enter the full phone number.

Member's Secondary Phone Number

Please enter a secondary phone number if available.

Member's Email

Confirm Email

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Street

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City/Township, State and Postal Code

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Parent's or Guardian's Name

Enter the parent or guardian's first and last name if the member is a minor.

Parent's or Guardian's Phone Number

Please enter the parent's or guardian's phone number if the member is a minor.

Teacher's Name

Enter the teacher's name if applicable.

Regular Membership

Please select your Regular membership level here if you have a Regular membership.

Donor Membership (Include Family Membership)

Please select your Donor membership level here if you have a Donor membership.

Lifetime Membership (Include Family Membership)

Please select the Lifetime Membership level if you have a Lifetime membership.

What type of harp do you play?

What type of Chapter events interest you the most?

What Type of Chapter events interet you the least?