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Membership Application Form

Violin Society Of America
48 Academy Street
Poughkeepsie, NY 12601-4111 USA

Please fill out form on your screen and hit Submit,
or fill out form on your screen - Print - then Mail or Fax:

Last Name: First Name: Street Address: City: State/Province: Zip/Postal Code: Country: Home Phone: Work Phone: ext: Fax Number: E-mail: Spouse: Occupation: Violin areas of interest:

Check type of membership:

Renewal - add $15 if membership has expired $50 Individual (USA,Canada,Mexico) $65 Individual (outside North America) $75 Library/Institution $20 Full-Time Student (USA, Canada, Mexico) $35 Full-Time Student (outside North America) School

Payment Information:

Additional donation of $ Check enclosed, payable to VSA, in US funds, drawn on US bank Charge my credit card: Visa Mastercard American Express Account Number: Expiration Date: Signature:

Skills I can offer to the VSA:

advertising/marketing appraisal clerical writer speaker convention administrator computer finance legal security
I understand that my membership includes a subscription to the Journal and the newsletter for one year, entitles me to attend Society events at reduced fees and to enter the International Competitions.


Mail Applications To:

The Violin Society Of America
48 Academy Street
Poughkeepsie, NY 12601-4111 USA
(845) 452-7557 . (845) 452-7618
membership@vsa.to


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